Effectiveness of using video modeling for teaching safety skills for children with autism and other developmental disabilities
by
Stephanie A. Sokolosky, M.P.S.
A Dissertation
In
SPECIAL EDUCATION
Submitted to the Graduate Faculty of Texas Tech University in Partial Fulfillment of the Requirements for the Degree of
DOCTOR OF EDUCATION
Approved
Devender R. Banda Chair of Committee
DeAnn Lechtenberger
Stacy L. Carter
Peggy Gordon Miller Dean of the Graduate School
May, 2011
Copyright 2011, Stephanie Sokolosky Stephanie Sokolosky, Texas Tech University, May, 2011
Acknowledgments
I want to take the opportunity to thank Jim and Jere Lynn Burkhart, and the Burkhart Center for Autism Education and Research for supporting my journey as a graduate student at Texas Tech University. The Burkhart Center staff, Janice Magness, Erin Lemon and Susan Voland, and Burkhart Center participants helped me remember the real purpose of continuing my education. My dissertation committee members, Devender R. Banda, DeAnn Lechtenberger, and Stacy L. Carter, provided me the personal and professional opportunities to expand my level of experience and knowledge. My family, including Sabrina Wicker, Jennifer Wicker, Ed Sokolosky, Wesley Sokolosky and Linda Westerburg, have always taken time to find humor in my adventures. I honor the memory of my parents, Lucille and Martin Sokolosky.
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Table of Contents
Acknowledgments...... ii
Abstract ...... vii
List of Figures ...... viii
I. Introduction ...... 1 Safety and Children with Developmental Disabilities and Autism ...... 2 Pedestrian and Street Crossing ...... 2 First Aid ...... 4 Unsafe People ...... 5 Fire Safety ...... 7 Video Modeling as an Intervention ...... 8 Purpose of Study ...... 10 Research Questions ...... 10 Definition of Terms ...... 10
II. Literature Review ...... 16 Developmental Disabilities ...... 16 Autism ...... 18 Historical Perspective on Autism...... 19 Adaptive Behaviors ...... 21 Safety ...... 22 Safety Interventions for Children and Adolescents with Developmental Disabilities...... 23 Developmental Disabilities and Pedestrian and Street Crossing...... 26 First Aid and Identification of Safety Concerns...... 28 Response to Lures of Strangers and Being Lost...... 30 Fire Safety...... 36 Other Safety Studies...... 39 Video Modeling ...... 40 Definition and Theoretical Framework for Video Modeling...... 40 Video Modeling and Children with Autism...... 42 Video Modeling and Social/Communication Skills...... 43 Video Modeling and Play Skills...... 48 iii Stephanie Sokolosky, Texas Tech University, May, 2011
Video Self-Modeling and Social Skills...... 50 Video-Self Modeling and Challenging Behaviors...... 53 Point of View Modeling (PVM)...... 55 Video Modeling Combined with Other Interventions...... 57 Using Technological Methods for Teaching Safety...... 60 Pilot Study ...... 62 Research Questions ...... 63
III. Methods...... 64 Participants ...... 64 Selection Criteria...... 64 Procedure for participant selection...... 65 Brad...... 65 Jerry...... 65 Jim...... 66 Monte...... 66 Richard...... 67 Settings ...... 67 Trainers/Interventionists ...... 67 Materials ...... 68 Dependent Variables and Measurement ...... 70 Independent Variable/Intervention ...... 71 Experimental Design ...... 71 Procedure ...... 72 Baseline ...... 74 Intervention ...... 74 Generalization ...... 75 Interobserver Agreement ...... 75 Procedural Integrity ...... 76 Treatment Acceptability ...... 77 Data Analysis ...... 78
IV. Results...... 79 Participants ...... 79 Brad...... 79 iv Stephanie Sokolosky, Texas Tech University, May, 2011
Jerry...... 80 Jim...... 81 Monte...... 82 Richard...... 83 Summary of Participants ...... 84 Treatment Acceptability ...... 85
V. Discussion ...... 88 Research Question 1: Is video modeling an effective method for teaching the safety skill to young children with developmental disabilities? ...... 88 Research Question 2: Will the safety skill learned through video modeling generalize across settings? ...... 95 Limitations ...... 97 Implications for Practice ...... 99 Conclusions ...... 100
References ...... 102
Task Analysis List...... 124
Texas Tech University IRB Signature Page ...... 125
Invitation to Participate ...... 126
District Research Approval ...... 127
Parent Consent Form...... 129
Parent Consent Form (Spanish) ...... 132
Teacher Consent Form ...... 135
Child Personal Data ...... 138
Teacher Training ...... 139
Data Collection Form ...... 141
Data Collection Form –Interobserver Agreement ...... 142
Procedural Integrity Form for Implementer Skill Assessment ...... 143
Teacher Treatment Acceptability Form ...... 144
v Stephanie Sokolosky, Texas Tech University, May, 2011
Parent Treatment Acceptability Form ...... 145
Parent Treatment Acceptability Form (Spanish) ...... 146
vi Stephanie Sokolosky, Texas Tech University, May, 2011
Abstract
Children with disabilities including autism spectrum disorders and other developmental disabilities often need training in safety-related areas. Literature indicates that video modeling has been effective in teaching play activities, as well as social and communication skills. In addition, there are few studies where young children with developmental disabilities, including autism, have been taught safety skills. Video modeling has been shown to be effective in teaching safety skills, however to date it has not been used in teaching these skills to young children with developmental disabilities.
The purpose of this study was to evaluate the effectiveness of using video modeling to train young children with autism spectrum disorders or developmental disabilities to walk around a 3-dimensional yellow safety marker used in many public locations. The marker indicated a wet area below the marker. Five students, between ages 5 and 6 years, watched a 2-minute video of an adult demonstrating the proper procedure for safely walking around the safety marker. After watching the video the student was prompted to walk down the hall, then reinforced for completing the task using a simple social reinforcement. An A-B design across subjects, with a generalization phase, was used to evaluate the effectiveness of the intervention. The results indicated that the use of video modeling was effective in training young children with developmental disabilities and autism spectrum disorders to learn this safety skill. In addition, the five participants successfully generalized the new safety skill to a novel setting. Results are discussed and implications for research and practice are provided.
vii Stephanie Sokolosky, Texas Tech University, May, 2011
List of Figures
1. Brad‘s performance during the baseline, intervention, and generalization phases ...... 80
2. Jerry‘s performance during the baseline, intervention, and generalization phases ...... 81
3. Jim‘s performance during the baseline, intervention, and generalization phases ...... 82
4. Monte‘s performance during the baseline, intervention, and generalization phases .... 83
5. Richard‘s performance during the baseline, intervention, and generalization phases .. 84
viii Stephanie Sokolosky, Texas Tech University, May, 2011
Chapter I Introduction
Safety is an important consideration in every setting and for all ages. The World
Health Organization (2009) reported more than 2000 accidental or unintentional injuries that result in death for children each day. Although parents and teachers strive to provide safe environments for children, some accidents are inevitable. As individuals with developmental disabilities including autism complete elementary through secondary academic programs, the ultimate goal for many will be to live in public communities and work within the general population. The opportunities for more inclusive experiences lead to increased independence with decreased supervision. Collins, Wolery, and Gast
(1992) have described the importance of teaching individuals with disabilities the value of engaging in safe practices, including recognizing and avoiding unsafe situations, and reacting appropriately to danger. Although the need for safety programs within school and home environments is acknowledged, safety training for individuals with disabilities is limited. As individuals reach adulthood, the transition from supervised to semi- independent or independent settings emphasizes the importance of having skills that support the highest level of independence. Safety knowledge is critical in becoming independent. Since it takes a longer time for individuals with disabilities to achieve mastery, this training must begin as early as possible. Consequently, safety training needs to begin while children with disabilities are young. Several of the studies presenting research on safety training for children with developmental disabilities are described in the next section.
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Safety and Children with Developmental Disabilities and Autism
Children with developmental disabilities have been described as individuals who demonstrate a variety of delays or deficits that limit their ability to participate in daily activities (Braun, Yeargin-Allsopp & Lollar, 2009). Whereas, a child with autism exhibits impairments in communication/language and social skills, as well as, a display of a restricted or repetitive interest or behavior may also be included (Lord, Risi, DiLavore,
Shulman, Thurm, & Pickles, 2006). In both disability classifications, individuals exhibit a broad range of functioning abilities, including deficits in adaptive behaviors that limit the individual‘s ability to become self-sufficient (Doll, 1953). Consequently, skills contributing to achieving the highest level of independence and a productive life often need to be explicitly taught. Personal safety training is one of these skills. Current research addresses the need for personal safety training for individuals with developmental disabilities, although, the studies are limited.
Mechling (2008) compiled a 30-year review of safety skill instruction for individuals with intellectual disabilities. Within the 36 studies included in the review, only 3 were conducted with children as subjects. In her review, Mechling organized the studies into the following categories: pedestrian and street crossing, first aid and identification of safety concerns, response to lures of strangers, and fire safety. These categories will provide a framework for organizing the studies for this section.
Pedestrian and Street Crossing
In one pedestrian safety study, Horner, Jones and Williams (1985) taught two participants, ages 12 and 53, the safety skill of crossing streets. This safety study combined a variety of street settings and traffic conditions. Consequently, the training 2 Stephanie Sokolosky, Texas Tech University, May, 2011 variables included 20 streets systematically selected to represent a range of street crossings, and 20 additional street crossings selected by parents and guardians of the participants. These streets were not streets that were familiar to the subject. The results of the study indicated that even though the participants had limited intellectual ability, they were able to be efficiently and effectively trained to cross unfamiliar streets.
In another similar study, Spears, Rusch, York and Lilly (1981) taught pedestrian- related skills that emphasized the ability of a child who lived in an institution to transition independently from the school bus to the facility. The pedestrian portion of this skill was walking from the school bus to the institution where he lived. The primary goal of the research was to identify an effective method for teaching the child to increase his independence in this transition so the extensive staff supervision was no longer required.
The researchers used a multiple baseline design to teach the behavior clusters of walking to the building from the bus, placing the schoolbag in the child‘s bedroom, then entering the facility playroom. The dependent variable represented the number of steps requiring verbal or physical staff assistance, resulting in pacing prompts, as well as prompt withdrawal. After 45 training days, the participant was trained to arrive home, then independently demonstrate the desired skills, except for 5 of the substeps.
In the pedestrian-related studies, the subjects were able to demonstrate safe pedestrian skills with an enhanced level of independence. As children mature, or as individuals with developmental disabilities spend more time in the general population, safely crossing streets and increased safety while transitioning from the bus to a residential facility contribute to the child‘s independence.
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First Aid
The safe use of first aid procedures is another area that contributes to enhanced independence for individuals with developmental disabilities and autism. In the three studies below (Marchand-Martella and Martella, 1990; Spooner, Stem & Test, 1989;
Winterling & Gast, 1992), the researchers explored effective methods for providing safe instruction for study participants where their ages ranged for seven years old through high school.
In the first aid study, Winterling and Gast (1992) prepared high school students to remove and discard broken materials from the sink, countertop, and floor. The multicomponent treatment combined orientation lecture, pretask demonstration and
5-second constant time delay procedure. The multiple probe design evaluated the effectiveness of the treatment. Multiple exemplars included broken plastic cups, plates, and glasses in differing sizes, shapes, and colors. The results indicated that this method was effective for training these students; however, the follow-up probes at one week and one month provided mixed results.
In another study (Spooner et al., 1989), three adolescents were taught to use 911 to contact emergency assistance, as well as to treat minor injuries and to apply first aid for choking. The multiple baseline across behaviors design was used to measure the effectiveness of this training method for teaching students the first aid procedures, and the 6-and 12-week probes indicated skills were maintained. The two-step intervention included a group discussion and individual training, with an independent variable of identifying the number of steps independently completed.
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In a final first-aid related study, Marchand-Martella and Martella (1990) taught treatments for minor bleeding wounds and minor burns. Four participants, ages 7 to 11, were taught the two first aid skills of treating minor wounds that continue to bleed, and treating minor burns. A multiple baseline design across first aid skills was used to measure the effectiveness of the program. The program included an activity book with task-analyzed illustrations of the methods for treating the injuries, puppets, a first aid kit, reinforcement, and corrective feedback. Pretraining and posttraining assessments were combined with probes to evaluate the effectiveness of the training method. In addition, generalization measurements were used with treatments of self-wounds and wounds on others. The interventions were successful, and generalized skills were maintained up to
66 weeks across settings and in novel situations.
The studies emphasizing first aid training provided examples of a range of effective methods for teaching individuals with developmental disabilities the importance of safe responses in a variety of settings. In addition, the authors presented methods that addressed a wide range of age-appropriate training.
Unsafe People
As individuals with developmental disabilities are presented with opportunities to come into contact with the general population, it is prudent to teach them about safety as it is related to contact with a variety of people. In three studies (Gast, Collins, Wolery, &
Jones, 1993; Watson, Bain, & Houghton, 1992), the researchers provide instruction about the importance of identifying individuals who may not be safe or may create an unsafe environment through peer pressure or bullying. In a third study, Collins, Hall, Rankin and
Branson (1999) developed a training program addressing peer pressure concerns. 5 Stephanie Sokolosky, Texas Tech University, May, 2011
Two studies addressed the importance of identifying people who are not safe
(Gast et al., 1993, and Watson et al., 1992). Gast et al., (1993) used a multiple probe design across subjects to evaluate the effectiveness of a simulated training program for training appropriate responses to lures of strangers. The subjects were 3 to 5 years old, and the simulation training was provided in their respective preschool classrooms. The procedure combined constant time delay with multiple exemplars including a variety of strangers, lures, and sites. The children quickly acquired the correct responses; however, generalization was not effective. With in vivo training, the acquisition, maintenance, and generalization for criterion were achieved with three of the four subjects.
Collins et al. (1999) provided training for managing peer pressure. The participants were secondary students in a self-contained classroom. The behaviors most susceptible to peer pressure were identified. The training sessions occurred within the classroom, including a definition of the inappropriate behavior, consequences of the behavior, modeled correct responses, concluding with student role playing of appropriate responses. A constant time delay procedure was used, correcting both prompted and unprompted responses. A staggered instruction method was used where one student participated in the training, then after achieving criterion, the second student began the training. Confederate students participated, providing peer pressure as instructed.
Generalization daily probe sessions were integrated into daily school routines including novel settings, as well as novel peers and peer pressure situations. The results indicated that the program was effective for preparing individuals with developmental disabilities to manage peer pressure.
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Watson and colleagues (1992) used a multiple probe design to teach strategies for inappropriate invitations by strangers. There were seven subjects, 6 to 8 years old, with developmental disabilities including intellectual limitations. The direct instruction procedure was used for training the 15 lessons in the students‘ classroom and school playground. Six of the seven students generalized the skills across abductors. A 14-day follow-up indicated that the gains were maintained.
Since communication and social deficits are hallmarks for autism, it is critical that individuals with this disability receive explicit training in preparation for contact with the general public. Misunderstandings that result from misread social cues contribute to social isolation. Whereas, if students have received training that help them identify circumstances that may be socially unsafe, some of these misunderstandings may be avoided. Consequently, training to identify individuals who may be unsafe could help avoid misunderstandings, or potentially dangerous situations.
Fire Safety
In teaching safety skills to individuals with developmental disabilities, fire safety is a major concern because it is difficult to find a safe way to teach fire safety. However, one research project addressed that critical topic. Haney and Jones (1982) taught fire safety to four participants, 12 to 16 years of age, residing at a community living arrangement. A multiple baseline design across participants was used to evaluate the effectiveness of training the participants to exit the home setting. The procedure included specific instructions, modeling, behavioral rehearsal, and social and tangible external reinforcements. Simulated cues were integrated into the training (e.g., a heating pad on a door to indicate a hot door, and a fan blowing hot air). As a participant met the 7 Stephanie Sokolosky, Texas Tech University, May, 2011 designated criteria, the training was generalized to other rooms. In addition, the participants maintained the emergency exit skills over time. This carefully designed study demonstrated an effective method for teaching safety skills to persons with a variety of disabilities.
Although there are many other aspects to consider when addressing the important topic of safety training for individuals with developmental disabilities, the current study emphasized research involving children as the subjects. In addition, studies using a single subject design were reviewed because of their similarity to the current research.
Video Modeling as an Intervention
Video modeling is one strategy that has been shown to be effective for individuals with developmental disabilities. Video modeling is an intervention that has been used to teach individuals with autism a wide range of skills. Video modeling is defined as a method for teaching an individual a novel skill where the learner observes a training video then the learner imitates the actions observed in the video (Haring, Kennedy,
Adams, & Pitts-Conway, 1987). Observational learning is the theoretical basis for video modeling with Bandura‘s (1968) research conceptualizing that an individual observes another person demonstrating a novel behavior, then the observer imitates that behavior.
Bandura also wrote that most humans learn by first observing others, then modeling their observed behaviors. Observing carefully designed training videos for training specific skills is an example of an application of Bandura‘s observational learning theory.
Video modeling has been used to explicitly teach skills to individuals with autism, including social/communication skills, play, perspective-taking, and methods for
8 Stephanie Sokolosky, Texas Tech University, May, 2011 improving challenging behavior. Video modeling has been used as a single intervention, but it has also been used in conjunction with other interventions. Several studies exemplify the use of video modeling for teaching social and communication skills, (e.g.,
Apple, Billingsley, & Schwartz, 2005; Charlop, Gilmore, & Chang, 2009; Charlop &
Milstein, 1989; Charlop-Christy, Le, & Freeman, 2000; Nikopoulos & Keenan, 2003;
Simpson, Langone, and Ayers, 2004; Taylor, Levin, & Jasper, 1999). Video modeling has also been useful in teaching play skills (D‘Ateno, Mangiapenello, & Taylor, 2003;
MacDonald, Sacramone, Mansfield, Wiltz, & Ahearn, 2009; Reagon, Higbee, &
Endicott, 2006). The skill of perspective-taking has been successfully taught through video modeling (Charlop-Christy & Daneshvar, 2003; Hine & Wolery, 2006). Another category of video modeling is video self-modeling (VSM), which has been effectively used in teaching children social skills (Thiemann & Goldstein, 2001; Wert & Neisworth,
2003), and for improving challenging behaviors (Buggey, 2005). In other studies, video modeling has been combined with other methods to enhance a single intervention
(Maione & Mirenda, 2006; Murzynski & Bourret, 2007; Simpson et al., 2004). These studies demonstrate the effectiveness of video modeling for teaching new skills to children with disabilities.
There are many examples for using video modeling for teaching a variety of novel skills to individuals with disabilities. These methods are also used for improving existing skills. However, none of these studies explored the use of video modeling for teaching safety skills to young children.
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Purpose of Study
The purpose of this study is to determine if video modeling would be an effective intervention for teaching safety skills to young children with developmental disabilities, including autism. First, video modeling has been demonstrated to be effective for teaching skills to individuals with developmental disabilities. However, prior to 2011, there has not been a study exploring the effectiveness using video modeling for teaching safety skills to young children with developmental disabilities. Second, safe environments and carefully completing daily tasks contribute to the presumption that injuries may be avoided. However, since unintentional injuries occur, it is important to prepare children with developmental disabilities through safety training. There is a dearth of safety skills studies using young children as subjects. Third, this study will contribute to the current literature on the use of video modeling as well as safety training for young children.
Research Questions
The following research questions will be answered in this study:
1. Is video modeling an effective method for teaching the safety skill to children
with developmental disabilities and autism?
2. Will the safety skill learned through video modeling generalize across
settings?
Definition of Terms
AB Design: An AB single subject study refers to the two phases of an intervention: A represents baseline, and B represents the intervention. Once a stable
10 Stephanie Sokolosky, Texas Tech University, May, 2011 baseline is established, the intervention begins. Intervention data are collected and recorded and compared to baseline data, and an inference may be made about the effectiveness of the intervention (Alberto & Troutman, 2009).
Adaptive behaviors: Adaptive behaviors are daily activities that contribute to one‘s ability to be self-sufficient (Doll, 1953). In order for an individual to meet eligibility as a person with developmental disabilities, there must be limitations in at least three of the following behavioral categories: language, mobility, learning, self-help and independent living (Campbell, Schopler, Cueva, & Hallin, 1996).
Asperger’s Syndrome (AS): Asperger Syndrome is developmental disability and is a subtype of Pervasive Developmental Disorder/Autism Spectrum Disorder. The behavioral characteristics of AS include onset often later than three years of age, with a minimum of an average intellectual ability. Some of the social characteristics include difficulty interpreting nonverbal cues, alienation from others, stereotyped behavior patterns, and fascination with restrictive interests. Communication content may be marked by focus on circumscribed interests, amassing factual details, and a tendency to focus on the favored topics (Klin, Pauls, Schultz, & Volkmar, 2005b).
Autism: Autism is a developmental disability, a subcategory of Pervasive
Developmental Disorder, based on the following behaviors: impairment in social interaction and reciprocity; impairment in communication; and a restricted repetitive and stereotyped pattern of behaviors or interests (American Psychiatric Association, 2000).
Developmental Disabilities: Developmental disabilities contain a range of chronic conditions including cognitive, physical, (e.g., motor or sensory), speech, language, or
11 Stephanie Sokolosky, Texas Tech University, May, 2011 psychological impairment (World Health Organization, 2009). The disability must be manifested prior to age 22 with its impact lasting a lifetime (Campbell et al., 1996). The severity of the disability is determined by limitations in adaptive skills restricting activities of daily living (Braun et al., 2009).
Feedforward: Feedforward is a subclassification of video self-modeling where the individual is improving a skill already present in his or her behavioral repertoire and uses a video of himself or herself modeling the behavior shown in a video. This method is used when the learner has not yet mastered the skill (Dowrick, 1999).
Functional relation: A functional relation is a verbal statement summarizing the results of an experiment that describes the relationship between a response and variable environmental conditions (Cooper, Heron, & Heward, 2007).
Generalization across settings: After a target behavior has been demonstrated in the setting where the training occurred, a skill is generalized across settings when that target behavior is performed in another place or stimulus situation that is different from the instructional setting (Cooper et al., 2007).
In Situ Assessment: Assessments that occur in a natural setting (Beck &
Miltenberger, 2009).
In vivo: In a study that uses in vivo method, the participant remains in the naturalistic setting. This technique is used when the intervention may be more effectively implemented in a life-like setting (Rhea, 2005).
Multiple baseline design: A multiple baseline design is an experimental design where two or more behaviors are concurrently measured in a baseline condition, followed 12 Stephanie Sokolosky, Texas Tech University, May, 2011 by a treatment variable for one of the conditions, while the baseline condition is maintained for the other behaviors. After a stable change is documented for the first behavior, a treatment variable is applied to the subsequent behaviors in the design.
Experimental control is demonstrated if the target behavior changes as a function of the application of the treatment variable (Cooper et al., 2007).
Observational learning: Observational learning theory is based on the concept that when an individual observes another person demonstrating a novel behavior, then the observer reproduces the target behavior (Bandura,1986). Bandura (1968) wrote that most humans learn by observing others.
Perspective-taking: Perspective-taking is the ability of an individual to anticipate or understand the mental state of another person resulting in the ability to accurately predict another person‘s behavior. Many individuals with autism are unable to demonstrate this skill causing them to misunderstand another‘s attitude or feeling particularly if it differs from their own (Baron-Cohen, 1989).
Pervasive Developmental Disorder: Pervasive Developmental Disorders (PDD) are characterized by severe and pervasive impairments in several areas of development including social interactive and communication skills, as well as the presence of stereotyped behavior, interests or activities. The broad category of PDD includes the five developmental disorders: Autistic Disorder, Rett‘s Disorder, Childhood Disintegrative
Disorder, Asperger‘s Syndrome (AS), and Pervasive Developmental Disorder Not
Otherwise Specified. These disorders are typically evident by five years of age and frequently include intellectual limitations (American Psychiatric Association, 2000).
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Pervasive Developmental Disorder--Not Otherwise Specified (PDD-NOS): PDD-
NOS is a severe and pervasive developmental impairment with social interaction deficits, as well as verbal and nonverbal communication impairments. In addition, stereotyped behavior, interests, and activities are often present. PDD-NOS is a subclassification within the PDD broad disability category (American Psychiatric Association, 2000).
Positive self-review: Positive self-review is a video self-modeling method where the individual learning the skill is also the model. In this scenario, the learner has not yet mastered the skill and employs video self-modeling to provide a favorable model of the target skill. The video provides an example of a behavior that is currently in the learner‘s repertoire but needs improvement (Dowrick, 1999).
Safety: Teaching safety skills to individuals with disabilities includes social safety skills which include verbal or nonverbal behaviors that may be primarily preventive or reactionary. With preventive measures, the individual avoids potential danger before it occurs. Whereas, reactionary measures include escape or termination of situations or conditions that are presently occurring (Clees & Gast, 1994).
Video modeling: Video modeling is a training method for teaching an individual a novel skill. The learner observes a video of himself or herself, or another individual performing the target skill, then the learner imitates the actions observed in the training video (Haring et al., 1987).
Video prompting: Video prompting is a method for training a sequence of complex or multipstep skills. Each step, based on the task analyses of the complex skill, is viewed by the participant. The goal is for the participant to follow the prompts and
14 Stephanie Sokolosky, Texas Tech University, May, 2011 independently complete the task (Van Laarhoven, Kraus, Karpman, Nizzi, & Valentino,
2010).
Video self-modeling: Video self-modeling is an application of video modeling where the learner is the model in the video demonstrating the target skill. The individual observes himself or herself successfully performing the target behavior. This method is highly effective particularly with individuals who enjoy observing themselves in a video
(Dowrick, 1999).
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Chapter II Literature Review
The purpose of this chapter is to describe literature on issues related to the use of video modeling with young children who have developmental disabilities, including autism, and teaching safety skills. The first part of the review provides an overview of autism and developmental disabilities. The following topics are selected for this literature review: (a) definition of developmental disabilities, (b) definition of autism and its historical perspective, (c) role of adaptive behaviors in autism related to safety, (d) significance of safety when helping children with disabilities, (e) definition of video modeling, (f) video modeling to teach communication skills using others as models, (g) video modeling to teach socialization skills, (h) video modeling to teach play skills, (i) video modeling to improve challenging behavior, (j) video modeling and perspective- taking, (k) gaps in the existing literature, and (l) rationale for the present study and research questions.
Developmental Disabilities
Developmental disabilities have been described as a heterogeneous group of conditions that significantly limit one‘s ability to participate in daily activities (Braun et al., 2009). The limitations vary depending on the characteristics of the impairment(s).
Individuals who are considered to have developmental disabilities have significant functional limitations in three or more of the following areas: language, mobility, learning, self-help, and independent living. This chronic disability is manifested prior to age 22, and the impact lasts a lifetime (Campbell et al., 1996).
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The World Health Organization (2009) defined developmental disability as a range of chronic conditions including cognitive, physical (e.g., motor, sensory), speech, language or psychological impairment. In the Boyle and Decoufle (1994) report incorporating statistical data from the 1994-95 National Health Interview Survey on
Disability (NHIS-D), there were estimates that 16.8% of children 17 years of age were reported to have at least one developmental disability. In addition, 30% had more than one developmental disability, and autism was one of the developmental disabilities. In contrast to the previous study on the prevalence of developmental disabilities, Kogan,
(2009) and his colleagues surveyed parents of children from 3 to 17 years old, estimating that 110 per 1000 U.S. children were identified by parents as having a diagnosis of autism.
Individuals with developmental disabilities are a heterogeneous group of individuals with chronic conditions that usually result in substantial activity limitations.
Most have intellectual and other multiple impairments where the type and extent of activity limitations vary depending on the specific characteristics. Since the ultimate goal is for each individual to live as independently as possible, it is important for educational goals to improve activity level and prevent activity limitations (Braun et al., 2009). In consideration of the hopeful goal of positive adult outcomes, safety training should be emphasized throughout the educational experience.
For individuals with autism, the relationship between adaptive functioning and autism symptomatology remains unclear (Klin, Saulnier, Sparrow, Cicchetti, Volkmar, &
Lord, 2007). Adaptive behaviors are indicators of one‘s ability to function in the real
17 Stephanie Sokolosky, Texas Tech University, May, 2011 world, and include taking care of one‘s personal needs, participating in group and community activities, and interacting with others in negotiating the social world. For some individuals with autism, adaptive impairments may create more difficulties in the community than one may expect based on cognitive delays. The researchers also found that the individuals in their study failed to make gains in adaptive skills commensurate with chronological growth. Consequently, even though the subjects were higher functioning individuals with autism spectrum disorders (ASD), they still presented restricted abilities to function in the real world. Consequently, the researchers concluded that adaptive skill instruction needed to become a priority in preparing these individuals for adulthood. In addition to adaptive skills instruction, specific safety awareness and targeted safety training enhanced the ability of many individuals with ASD to enjoy living independently.
Autism
Autism is a developmental disability and a complex neurodevelopmental disorder with a definition based on observed behaviors. In order for an individual to meet the established criteria for the diagnosis of autism, the following three conditions must be met: impairment in social interaction, impairment in communication and a restricted repetitive and stereotyped pattern of behaviors or interests (Lord et al., 2006). Pervasive
Developmental Disorders (PDD) is an umbrella term which encompasses five categories of developmental disorders and three of these categories are on the autism continuum:
Pervasive Developmental Disorder--Not Otherwise Specified (PDD-NOS), Asperger‘s
Syndrome (AS), and Autism. ASD is a term that is used in reference to individuals within this autism continuum. All individuals with ASD exhibit neurological disorders 18 Stephanie Sokolosky, Texas Tech University, May, 2011 with developmental delays and dysfunctions in the areas of social, communication and repetitive interests. Individuals with AS have intellectual ability that is within the average range or higher. Another term that is frequently used in research with individuals with
ASD is high functioning autism (HFA). Some researchers have tried to determine the differences between AS and HFA. However, Miller and Ozonoff (2000) concluded that even though there may be differences in terminology between AS and HFA, there are significant similarities and the interventions for individuals within both categories are essentially the same. Consequently, the descriptive categories of AS and HFA are frequently used interchangeably.
Historical Perspective on Autism. In concept, the diagnosis of autism has not significantly changed since its first use by Leo Kanner (1943). Kanner described cases in terms of abnormal development in three major areas: social reciprocity; abnormal language development, especially as it was used reciprocally with other people; and the desire for sameness, as evidenced in ritualistic behavior. Kanner‘s cases exhibited low ability and poor language in addition to the social limitations. Kanner felt these individuals were born lacking the typical motivation for social and affective interaction, thus were not interested in others. Consequently, he used the term autism to convey this egocentric preference (Klin, McPartland, & Volkmar, 2005a).
Shortly after the appearance of Kanner‘s work, in 1944, Hans Asperger published his paper on autistic psychopathy (Wing, 1981). Neither was aware of the other‘s research, although there were similarities in the two patient groups. Some, though not all of Asperger‘s cases, had high intellectual ability and were very verbal; however,
Asperger believed that difficulties in socialization represented the hallmark feature of his 19 Stephanie Sokolosky, Texas Tech University, May, 2011 patients. The patients documented in Asperger‘s cases had difficulty working in groups despite adequate cognitive ability and language skills (Klin et al., 2005b). Asperger advocated an educational approach where teachers would work to improve their students‘ strengths, and since these children did not function well in groups, he recommended individual attention. These students displayed a strong specific interest, and Asperger proposed using this special interest to guide their educational programming (Frith, 2004).
Although his research provided us with the initial descriptions of these children, Wing translated his work into English in 1981, and she coined the phrase Asperger Syndrome
(Wing). Kanner‘s and Asperger‘s original studies contribute to our understanding of
ASD. Researchers have explored the increase in the prevalence of autism, unlike most of the other developmental disabilities (Levy, Mandell, & Schultz, 2009). Kadesjö, Gillberg, and Hagberg (1999) reported that between 1960 and 1980, the prevalence ranged from 5 to 72 cases per 10,000 children in the United States and Europe, and was thought of as rare (Newschaffer et al., 2007). However, recently a U.S. Centers for Disease Control and Prevention (CDC) study on the prevalence of autism conducted by the Autism and
Developmental Disabilities Monitoring Network (2009), the investigators found that among 8-year-olds in the US in 2006, 1 in 110 were classified as having an ASD, compared to a 2002 estimate of 1 in 153. The CDC study was retrospective and reviewed records from 11 sites contributing to the Autism and Developmental Disabilities
Monitoring Network. Results from these sites indicated a 57% increased prevalence from
2002 to 2006. The participants were 8 years of age, which was selected because it represented peak prevalence. This startling increase emphasized the importance of autism as a public health concern (Mitka, 2010). Many children with autism and other
20 Stephanie Sokolosky, Texas Tech University, May, 2011 developmental disabilities exhibit deficits in adaptive behavior. Although adaptive skill levels do not contribute to a diagnosis of autism, an understanding of adaptive skills helps one understand the ability of a person with ASD to function in the real world (Klin et al.,
2007). Similarly, an understanding of one‘s adaptive skill levels may contribute to one‘s knowledge and understanding of safety, and thereby inform the best methods for safety- related training.
Adaptive Behaviors
ASD often co-occurs with intellectual limitations contributing to limited adaptive skills (Matson, Rivet, Fodstad, Dempsey, & Boisjoli, 2009). Doll (1953) defined adaptive skills as daily activities that contribute to one‘s ability to be self-sufficient. These same behaviors contribute to an individual‘s general functioning level and overall adjustment
(Goldberg, Dill, Shin, & Nhan, 2009; Lifshitz, Merrick, & Morad, 2008). Consequently, when deficits in intellectual and adaptive areas are identified, individuals with these deficits are likely to demonstrate less independence and reduced self-sufficiency (Soenen,
Van Berckelaer-Onnes, & Scholte, 2009). These broad limitations are often a result of the core deficits of autism that contribute to an over-reliance on adults for daily functioning. These deficits are found in social skills, as well as functional and self-help tasks. Some of the restricted social skills that impact many individuals with autism include deficits in the ability to initiate and regulate social interactions, spontaneously play with peers, give and receive compliments, and maintain a conversation topic selected by another person. Limitations in the areas of functional and self-help skills are other deficit areas for individuals with autism, including a practical use of money, brushing teeth and washing one‘s face, as well as household chores such as meal 21 Stephanie Sokolosky, Texas Tech University, May, 2011 preparation. The combination of reduced intellectual and adaptive abilities creates an opportunity for vulnerability within this population (Snell et.al., 2009). Parents report concerns as their children progress into adulthood and moving beyond access to school resources. These concerns include postschool opportunities, employment, housing, as well as health and safety (Bianco, Garrison-Wade, Tobin, & Lehmann, 2009). Whether individuals are able to live and work independently, or remain under the supervision of caregivers, safety is a concern for everyone, particularly individuals who may have a developmental, physical, or mental delay. According to the CDC (2008), an average of
12,175 children between 0 and 19 years of age died from unintentional injuries in the
United States between 2000 and 2006. Despite caregivers‘ best efforts, accidents are a serious concern. With effective safety training, there may be fewer accidents leading to serious injury or death. Consequently, the importance of safety training and the development of safe daily practices are extremely important for everyone, particularly individuals with developmental disabilities, including those with ASD.
Safety
Safety and the prevention of accidental injuries are important for everyone. A primary responsibility for parents is to help children avoid unintentional injury. The goal of most educational and training programs is to prepare individuals with disabilities to live as independently as possible in the community (Freagon, Wheeler, & Hill, 1983).
Since individuals with developmental disabilities exhibit a range of limiting characteristics that directly impact their ability to remain independently engaged in the community, training in safety and injury prevention is essential for each individual.
Some individuals may lack the ability to identify risk and recognize circumstances that 22 Stephanie Sokolosky, Texas Tech University, May, 2011 need to be avoided. Consequently, individualized safety programs may be needed
(Gaebler-Spira & Thornton, 2002). Others may have physical restrictions or limitations that contribute to the need for additional support in the community.
Although most educational programs emphasize academics, personal safety is another important skill contributing to a productive life. When developing an
Individualized Educational Plan (IEP), safety goals become an integral component for all ages. When students are young, safety concerns focus on playground safety (Hudson,
Thompson, & Olsen, 2005) or safely crossing the street. As students progress, personal safety includes recognizing safe and unsafe situations, as well as identifying individuals who may be unsafe, or developing a problem solving approach in case a dangerous situation occurs (Mechling, 2008). In addressing safety training for children with developmental disabilities, researchers have provided suggestions for implementing safety interventions at home and school.
Safety Interventions for Children and Adolescents with Developmental
Disabilities. Safety skills instruction has been found to be effective for individuals with developmental disabilities. Gaebler-Spira and Thornton (2002) addressed the importance of injury prevention for children with disabilities. Their research provides guidance for pediatricians who provide medical care for children with disabilities. The researchers emphasized the importance of modifying existing safety programs, or in some cases, designing unique interventions determined by the severity of the child‘s disabilities. The prevention categories included injuries related to (a) maltreatment, (b) unintentional injuries, (c) motor vehicle-related, (d) falling, (e) fire, (f) drowning, and (g) homicide and
23 Stephanie Sokolosky, Texas Tech University, May, 2011 suicide. The authors suggested strategies and specific areas of concern that they noted for each category.
Accidental falls, particularly in a bathroom, contribute substantially to unintended injuries. Among U.S. children younger than 18 years, Mao, McKenzie, Xiang and Smith
(2009) reported that an estimated 791,200 bathtub-and-shower-related injuries were treated in emergency rooms from 1990-2007. In this study, the researchers retroactively analyzed data collected through the National Electronic Injury Surveillance System
(NEISS) through the Consumer Product Survey Commission (CPSC). The results indicated that there was a need to increase prevention efforts to decrease the incidence of slips, trips and falls in the bathtub and shower. This is another example where safety training could contribute to a positive outcome.
With an emphasis on community instruction and access to the least restrictive environment, Collins, Wolery, and Gast (1991) administered a survey to parents (n = 23) and professionals (special educators, n = 23; university personnel n = 17). The survey addressed safety skills within special education programs across Kentucky, comparing responses from parents and professionals. Although there was extensive overlap between the two responding groups, there were some differences. Major concerns included exposure to unfamiliar animals, water recreation safety and responding to strangers.
Parents of elementary children expressed additional concerns regarding kitchen safety, bathroom and grooming safety, inclement weather safety, meal safety, and using public restrooms. Parents of adolescents identified additional safety concerns of adjusting water temperature, cleaning up broken items, proper use of matches or lighters, street safety and
24 Stephanie Sokolosky, Texas Tech University, May, 2011 basic first aid. This survey gave parents an opportunity to voice their safety concerns regarding their children with special needs.
Child abduction is another safety-related concern, and training programs have been developed to help children make safe choices. In a recent study, Beck and
Miltenberger (2009) compared the effectiveness of a commercially available program to in situ training by parents, teaching abduction prevention to their children. In this multiple-baseline design, there were six participants, 5 girls and 1 boy, ages 6 to 8 years old. The assessment training occurred in the homes as well as community locations. The study evaluated a training Safe Side DVD (Walsh & Clark, 2009) entitled ―Stranger
Safety‖ designed to teach abduction safety to children ages 5 to 10 years. The results indicated that the DVD training, when used alone, failed to teach children to use a safe response when approached by strangers in the community. However, the researchers added in situ training where parents provided their children with individual instruction on the importance of safe responses to strangers. The in situ training was effective in teaching the safety skill, following the ineffective training of the information-based training. Although safety training programs may be efficacious, it is important that the effectiveness for an individual child be carefully evaluated.
Although the importance of safety training for individuals with developmental disabilities is accepted, it is important to note that Mechling‘s (2008) review of safety research for individuals with disabilities included 36 studies from 1976 through 2006, and only three studies included children as subjects. The studies included in Mechling‘s review focused on teaching personal safety to individuals with intellectual disabilities. In this study, Mechling grouped the studies into six areas of instruction including the 25 Stephanie Sokolosky, Texas Tech University, May, 2011 following: (a) pedestrian/street crossing; (b) home accident prevention; (c) application of first aid (including identification and reporting illness); (d) response to lures or advancement of strangers; (e) fire safety; and (f) emergency use of telephones. These categories will be used to organize the studies contributing to this portion of this review of safety literature. Although there has been an increase in safety-related articles since
2008, the current body of literature has a relatively small number of these studies, and very few interventions where children were the study subjects. This confirms the need for studies to evaluate the effectiveness of interventions for training children with disabilities in the area of safety across a variety of everyday situations and circumstances.
Developmental Disabilities and Pedestrian and Street Crossing. Even though safe pedestrian skills are practiced throughout most communities, studies teaching this important skill are limited. Two studies addressed teaching pedestrian and street crossing skills. First, Horner and colleagues (1985) applied a multiple baseline probe design across three individuals, ages 12 to 53, with developmental disabilities and intellectual limitations for training street crossing on a street in their home town. The one-to-one sessions were conducted five days per week over a period of 20-40 minutes. The trainer‘s instructions, ―Cross when you are ready,‖ were paired with verbal and physical prompts when needed. Social praise and tangible reinforcement ($.25 per session) were provided to participants. Error corrections were presented when needed (i.e., ―Stop. The light says ‗Don‘t Walk‘‖). All feedback, assistance, and praise were gradually faded during the trials. Performance was also evaluated on streets that were unfamiliar to the participants. The outcomes provided three significant results: (a) a functional relationship between the training approach in this study and generalized street crossing, 26 Stephanie Sokolosky, Texas Tech University, May, 2011
(b) a measurement strategy for assessing the experimental control in generalized responding, and (c) a demonstration of social validation for the experimental effects.
These outcomes contributed to the generalization of this skill, the ultimate goal for this training.
In a second study, Spears et al. (1981) taught improved behaviors to a child with significant intellectual limitations, resulting in increased independence when transitioning from the school bus to the residential living facility. The specific skills taught included walking to the building from the school bus, placing school bag and coat in bedroom, and entering the playroom. The student began the behavior chain by walking across a parking lot to enter the building. The study incorporated pacing prompts on steps requiring assistance within the behavior chain leading to acquisition. An additional advantage was that as the student‘s independence in arrival from school improved, his decreased need for assistance resulted in increased self-confidence. From a broader perspective, as the participant demonstrated a higher level of independence in arriving home, the staff increased their expectations with positive results. The staff began to view the child as more competent, such as expecting more complex communication from him, requiring a specific sign or verbalization rather than accepting a simple gesture. As the participant increased independence, the requirement for staff time decreased. With the pacing prompts, the participant increased his ability to remain on task, leading to the possibility of increased time in the community. Overall, the intervention supported this child‘s ability to remain on task and acquire more complex behaviors with minimal verbal prompts. These results support the possibility of the subject gaining increased access to less restrictive environments. Although the pedestrian skill was only one 27 Stephanie Sokolosky, Texas Tech University, May, 2011 component of this study, it was essential for the progress of the subsequent steps. This is consistent with many safety skills—as individuals establish safe practices, they are able to develop an enhanced level of independence, thus open up opportunities for participating in less restricted settings.
First Aid and Identification of Safety Concerns. Although unintentional injury is not always preventable, training may contribute to improved outcomes following accidents. Three studies (Marchand-Martella & Martella, 1990; Spooner et al., 1989; and, Winterling & Gast,1992) exemplify training methods that emphasize injury prevention. A fourth study (O‘Reilly, Green, & Braunling-McMorrow, 1990) addressed prevention of home accidents. In the first study, Winterling and Gast (1992) trained individuals with disabilities to safely dispose of broken glass using three emergency procedures. Three high-school aged students with moderate disabilities were taught to remove and discard broken materials from the sink, countertop, and floor. The training location was the high school and incorporated a multicomponent treatment package for teaching safety skills where simulated materials were used initially, then replaced with actual broken plates and glasses. A multiple probe design was used to evaluate the effectiveness of the training program, then to collect data at one week and one month following training. Mixed results were reported; however, there were no student injuries during training.
In second study on safety training, Spooner et al. (1989) worked with students with developmental disabilities who were actively engaged in the general community.
With lessened adult supervision, a mastery of basic emergency procedures was needed.
Spooner and colleagues taught three safety and first aid skills to three adolescents who 28 Stephanie Sokolosky, Texas Tech University, May, 2011 exhibited limited cognitive ability. These skills included: using 911 to contact emergency assistance, treating minor injuries, and applying first aid in the event of a choking event.
In a similar study, Marchand-Martella and Martella (1990) taught four participants, mean age of 9 years, first aid skills of treating minor bleeding wounds and minor burns. The participants in the Marchand-Martella and Martella study lived in a group home and exhibited a range of behavioral and intellectual delays. Both studies used multiple baseline with simulated emergency events. In both studies, participants benefited from training and learned the first-aid skills then generalized the acquired first-aid skills to actual emergency situations. The ability to effectively use first-aid measures and identify critical safety concerns are integral components when participating in the general public.
Consequently, basic emergency skills contribute to increased independence, for children as well as adults.
In the fourth study (O‘Reilly et al., 1990), four adults with brain injuries were taught to use written checklists and use self-administered prompts to avoid in-home hazards. The adults, ranging in ages from 18 to 37, resided in a residential facility that was incorporated into a private rehabilitation facility for adults with brain injuries.
Common preventable home hazards were initially identified, and individualized task analyses were developed for the tasks that the participants failed to remediate. A multiple probe technique across rooms and participants was used to evaluate the effectiveness of the intervention. It included a baseline, checklist, and individualized task-analyzed phases implemented in each room. Outcome checklists were developed, and the participants used the written checklists as self-administered prompts for completing the tasks and remediating the hazards. The experimenter was not present in 29 Stephanie Sokolosky, Texas Tech University, May, 2011 the room while the participant was performing the tasks. After the participant left the room, the researcher evaluated the hazard remediation using the outcome checklist.
Praise was provided when hazards were corrected, and nonspecific reinforcement was provided when tasks were not completed. The results indicated that the participants achieved criterion rapidly with written prompts and delayed feedback. When generalizing the skills to other rooms, the results were varied.
The need for developing safe practices at home is essential to increased independence. These studies exemplify methods for creating opportunities for individuals with disabilities to function in less restrictive settings.
Response to Lures of Strangers and Being Lost. Another safety concern is the need for everyone, including children of all ages, as well as those with disabilities, to identify circumstances and people who are not safe. Since individuals with disabilities are integrated into the general public, self-protection has become increasingly important.
Parents of children with autism report the risk of physical safety is one of their main concerns (Ivey, 2004). Three investigators addressed unwanted invitations from strangers (Gast et al., 1993; Gunby, Carr, & LeBlanc, 2010; and, Watson et al., 1992).
These three studies proposed methods for teaching safe responses to individuals with limited cognitive abilities and children with developmental disabilities, when faced with stranger invitations. Collins et al. (1999) focused on teaching participants with cognitive limitations to resist peer pressure. Another fear of parents similar to interactions with individuals who are not safe, is the possibility of individuals becoming lost. Taylor,
Hughes, Richard, Hoch, and Coello (2004) proposed a practical solution for teens with autism who were lost from familiar adults. In another study, Feliciano, Vore, LeBlanc, 30 Stephanie Sokolosky, Texas Tech University, May, 2011 and Baker (2004) used a visual barrier to help a 53-year old woman decrease her opportunities to enter unsafe areas or become lost. The barrier helped the woman remain within safe areas in the adult day facility.
Watson et al. (1992) used multiple-probe design to teach students with limited cognitive abilities to use appropriate strategies when faced with unwanted stranger invitations. The participants were seven students attending a special education school, ranging in ages from 6 to 8 years. The training took place in the classroom and school playground, with generalization probes at a nearby park, and maintenance probe at a bus shelter in front of the school. The study emphasized teaching the participants three main behaviors: ―No‖ (i.e., say or gesture no); ―Go,‖ and (i.e., move away); ―Tell‖ (i.e., immediately report the incident). The students were taught the interventions in the school setting. The second phase was taught at the school playground where additional exemplars were incorporated into the study. Confederates ranged from 20 to 38 years and were known to the first author. The sessions were video-taped using a concealed camera. The results demonstrated that the participants improved their self-protective skills. However, two of the students made only marginal improvements. This study did exemplify the ability of the participants to generalize the ―No, Go, and Tell‖ behavior to other environments.
Gunby et al. (2010) had a similar goal of teaching young children with autism to respond safely to the lure of strangers. The study used a nonconcurrent multiple baseline across participants to measure the success of the program that combined behavioral skills training (BST) with an in situ feedback component. BST is a multi-component intervention combining instructions, modeling, rehearsal, and feedback (Miltenberger, 31 Stephanie Sokolosky, Texas Tech University, May, 2011
2008). The three participants, ranging in ages from 6 to 8 years, participated in a 27 hour per week intensive center-based program, and the training took place at this facility. The target behaviors were to teach the participants the following abduction-prevention responses: (a) to say ―no‖ when presented with an invitation from a stranger, (b) to leave immediately and run to a safe area, and (c) to immediately report the incident to a familiar adult. The BST training incorporated the use of verbal instructions, video modeling, live modeling, rehearsal with familiar adults and strangers, with praise and corrective feedback during the rehearsal performance. The results were consistent with previous studies confirming that BST is effective in teaching abduction-prevention to children (Miltenberger & Olsen, 1996). In addition, the combination of BST and in situ feedback strengthened the maintenance of the skill (Gast et al., 1993). The participants in this study acquired the skills and they were maintained at a 1-month follow-up. One participant generalized the skill in a community setting.
In the study completed by Gast et al. (1993), a constant-time-delay procedure was used to teach a safe response to the lures of strangers. A multiple-probe design across subjects was used to evaluate the effectiveness of the intervention. The four participants with developmental delays ranged in ages from 3 to 5 years. Simulated sessions were conducted at the preschool in various areas of the classroom, and other familiar school settings. The strangers were selected from the families and friends of investigators, varying in age, gender and physical characteristics. Although some of the children had previously seen these adults, it was inappropriate for the children to be willing to leave with them. Even though the appropriate response was quickly acquired, the response failed to generalize to probe sites. In addition, in vivo instruction provided the desired 32 Stephanie Sokolosky, Texas Tech University, May, 2011 response to strangers‘ lures in acquisition, maintenance, and generalization of the skill.
Generalization included novel exemplars of lures, strangers and sites.
In a similar study, Collins and colleagues (1999) developed a program for teaching students to resist peer pressure by saying ―No‖ and walking away when pressured to participate in an inappropriate behavior. The identified behaviors included using drugs, skipping class, or harming another person (i.e., stealing). Researchers enlisted same-aged students to act as confederates when approaching students with disabilities in a 10th grade communication class. An integral component was the necessity to incorporate a range of confederates to approach the students in a variety of ways to mimic a naturally-occurring peer pressure environment. The seriousness of confidentiality of the project was conveyed to the confederates. With inclusive settings, children with disabilities were provided with opportunities to interact in settings that could foster peer pressure. Since the five secondary students selected as participants spent most of their school day in community-based activities including domestic, community, and vocational training, a communications class provided the opportunity to interact with the non-disabled peers on a regular basis. Similar to the Gast et al. (1993) project, the students were taught the desired responses by applying an 8-step model, using a constant time delay. For example, in a role play a peer suggested, ―Let‘s skip class‖, and the teacher immediately told the participant to say ―No‖ and walk away as soon as the student made the suggestion. The teacher praised both prompted and unprompted correct responses. Daily probes were used to evaluate the effectiveness of the intervention with confederates conducting the daily probe. The evaluation of generalization to novel examples of peer pressure was not completed because the school 33 Stephanie Sokolosky, Texas Tech University, May, 2011 year ended. The authors suggested that the teachers should conduct periodic probe trials throughout the year once a student reached criterion. This study was particularly important because most students with disabilities have been included in general education programs, as well as community-based instruction. Many students with developmental disabilities would be easy targets for peer pressure.
These first four studies exemplified methods for training young individuals with developmental disabilities to say ―No‖ and either walk away (Collins et al, 1999) or request assistance from an adult (Gast et al., 1993; Gunby et al., 2010; Watson et al.,
1992). The fifth study in this section addressed the use of a vibrating pager as a prompt for requesting help when lost in a community setting. As individuals with special needs gain independence in accessing the community, traveling safely from one location to another becomes a critical skill.
Taylor et al. (2004) evaluated a practical solution for individuals who were lost in the community. The participants were three teenagers with autism, ages 13 to 17. These teens were taught to respond to a vibrating pager for seeking assistance in community settings. The study combined the use of a vibrating pager as a prompt for the student to give a communication card to an adult. On the communication card was printed the student‘s name and a statement about being lost and needing help. During the initial training, the participant was taught the correct response sequence of being paged, then finding an adult and saying ―Excuse me,‖ then producing the communication card and waiting to be reunited with the parent or teacher. All of the participants learned to respond to the pager prompt, and initially were provided with tangible rewards, which were eventually faded. The results indicated that the participants were able to produce 34 Stephanie Sokolosky, Texas Tech University, May, 2011 the card in response to the vibrating pager at school and in community settings. All of the participants learned the desired skill when separated from caregivers, as well as parents. This method required minimal training for the adults, and the ease of implementing the interventions made this method appealing, and enhanced social validity.
In the second study involving the safety aspects of mobility, Feliciano et al.
(2004) taught a woman with cognitive impairment to avoid traveling to unsafe areas. The
53-year old woman had bipolar disorder and probably dementia. In the adult day-care facility, she wandered independently around the area. There were locations that were restricted from client access because of hazards. Noncontingent attention and redirection were unsuccessful in decreasing the wandering. The intervention included the use of a visual barrier. When a turquoise fleece cloth was hung at the participant‘s eye level, the behavior decreased immediately without verbal instructions or eye contact.
Subsequently, stimulus changes were implemented, and the color and size of cloth changed, and ultimately the visual barrier was removed, and verbal reminders were successful as a redirection.
The four initial studies contributed to the important literature on teaching children of all ages the importance of identifying individuals from whom invitations were appropriate. The Taylor et al. (2004) study provided an effective means of training individuals to safely seek help when lost. The final study (Feliciano et al., 2004) provided an intervention that was easily implemented to help guide the woman to remain in safe areas in the facility. These studies contributed to the research literature that presents interventions that are effective for individuals with disabilities, and that address safety in 35 Stephanie Sokolosky, Texas Tech University, May, 2011 the community. However, there is paucity of studies, and future research in this area is needed.
Fire Safety. Fire safety is a concern that crosses all ages, as well as cognitive and developmental levels. Even though fire safety is extremely important, there is limited research on this topic for training children with disabilities. Haney and Jones (1982), as well as Bigelow, Huynen, and Lutker (1993) provided training to individuals with disabilities in safely escaping a fire. Tiong, Blampied, and LeGrice (1992) used video prompting in a fire safety program for adults. In another study with a related topic, individuals with cognitive limitations were taught to extinguish cooking fires, and video modeling was the method used for training (Mechling, Gast, and Gustafson, 2009).
In the first study, Haney and Jones (1982) designed a behavioral model for training individuals, ages 12 to 16 with severe cognitive limitations, to exit a home in a fire emergency. A multiple baseline across participants evaluated the effectiveness of the training. The training included instructions, modeling, behavioral rehearsal, and reinforcement. A variety of reinforcers, including social, tangible, and self- reinforcement, were applied, and for the students who met criteria, reinforcement was faded during maintenance. Training took place on the second floor of the group home where the bedrooms were located, with the goal of safely exiting the house. Training was generalized to second room, then a third room for participants achieving criteria.
Significant improvement was reported during training, as well as during maintenance over a 6-month period of time. The participants demonstrated their ability to perform the correct emergency responses in their actual home setting, and extended their competencies for the six months following. 36 Stephanie Sokolosky, Texas Tech University, May, 2011
In the second fire safety study (Bigelow et al., 1993), a nine-year-old female with autism was taught to appropriately and quickly exit her home in case of fire, in response to the verbal prompt of ―fire.‖ The ultimate goal was for the child to learn to respond to the fire alarm in her home by exiting and walking to a designated location outside. The researchers used shaping and a changing criterion design. The participant was trained to walk from the living room and continue out the front door, a distance of 11 feet. The child received reinforcements including edibles, praise, and affection from the caregiver waiting outside the door. Once the child learned this skill, the researcher moved farther from the door. At the study‘s conclusion, the participant continued walking to a distance of 22 feet from the door upon hearing either the verbal prompt or the fire alarm.
In the third study (Tiong et al., 1992), the researchers used video prompting to help four adults with cognitive impairments to safely exit their bedrooms in the event of fire. The researchers used a concurrent multiple probe across subjects design. The training occurred in a community house, but not a house where the participants lived.
Consequently, there was a necessity to transfer the training to the participants‘ own residences. A training video, including verbal instructions, consisted of the steps for each task in the sequence. The training sessions were conducted with the participants individually. There were four situations included in the training and the participants were asked to demonstrate the correct actions for a randomly selected situation. If the participant was unable to respond, a non-specific prompt was given. If an incorrect or no response resulted, the participant would view the video demonstrating the correct response, then the researcher said, ―Now you show me.‖ The participant practiced all four situations. The results indicated that video prompting was effective, and the four 37 Stephanie Sokolosky, Texas Tech University, May, 2011 participants learned the proper procedure for safely exiting the area. In addition, the skill was transferred to a novel bedroom, or their own bedroom.
In the related study (Mechling et al., 2009), video modeling was the intervention method for training individuals with intellectual disabilities to extinguish cooking-related fires. The three students, ages 19 to 21, completed their probe and instructional sessions in the kitchen of an apartment rented by the school program for home living training.
The equipment required for this training included a microwave, toaster oven, and stove, with generalization phase to an outdoor barbeque area. After watching the video, the students were given the opportunity to extinguish the fire using one of the methods demonstrated in the video. The three behaviors used in extinguishing the fires included the following: (a) scooping and releasing flour; (b) placing a lid on a pot or pan; and (c) using a fire extinguisher. Each extinguishing task had a separate video model, and captions were added for clarity. A simulated fire was used for the training sessions. A multiple probe design across behaviors, replicated by the three students, was used to determine the effectiveness of the intervention. After the student watched the video, out of the view of the student, the fire was lit by the investigator. The investigator waited for
3 seconds for the participant to initiate the appropriate fire extinguishing behavior. The student received verbal praise for responding and attempting to put out the fire. The students participated in all three extinguishing behaviors. The results indicated that video modeling was effective in training the students to extinguish the simulated materials, and generalized to novel examples using flames. In addition, maintenance probe sessions indicated that all of the students maintained their performance levels.
38 Stephanie Sokolosky, Texas Tech University, May, 2011
These fire safety studies contributed to the body of literature on safety training for individuals with disabilities. They exemplified that even in a risky setting, such as fire danger, a well-organized study provided a model for future training.
Other Safety Studies. In consideration of the importance of safety skills training for individuals with developmental disabilities, there were other studies that were not been included in this review. For purposes of exploring the literature that was related to safety training for individuals with developmental disabilities, including autism, the researcher selected articles that primarily included safety research where the participants were children or adolescents, however some studies with adult subjects were also included. Some categories of safety-related articles were excluded. One such category included studies where the participants did not have disabilities (Dancho, Thomas, &
Rhoades, 2008; Himle, Miltenberger, Flessner, & Gatheridge, 2004; Jones, Kazdin, &
Haney, 1981; Miltenberger, Flessner, Gatheridge, Johnson, Satterlund, & Egemo, 2004;
Miltenberger & Thiesse-Duffy, 1988; Peterson, 1984; Sowers-Hoag, Thyer, & Bailey,
1987; and, Yeaton & Bailey, 1978). Another safety-related research category that was excluded from the review targeted studies where adults who received the safety training rather than training the child (Tertinger, Greene, & Lutzker, 1984). There were other studies where safety training was provided to a group rather than individuals (Heck,
Collins, & Peterson, 2001; Johnson et al., 2006; Lehman & Geller, 1990; Poche, Yoder &
Miltenberger, 1988; Van Houten, Van Houten, & Malenfant, 2000; and, Yeaton &
Bailey, 1983).
Safe environments are a primary concern for families, schools and other community settings or organizations. Although these studies exemplify a variety of 39 Stephanie Sokolosky, Texas Tech University, May, 2011 training interventions, video modeling is another method that has been found to be effective for individuals with disabilities. In the subsequent sections for this review of literature, information is presented about video modeling as a practical intervention that has been used for training individuals with disabilities to acquire a broad range of skills.
Video Modeling
In this section, video modeling was explored, beginning with the theoretical basis, then continuing with two primary methods of video modeling based on the model category. In one, a person other than the study participant was the model for the video; the other category used the study participant as the model for the video, known as video self-modeling (VSM). Next, a section explored the suitability of video modeling for children with autism. Then, studies were reviewed where video modeling was effective for learning social/communication and play skills, and improving challenging behaviors.
In conclusion, interventions were discussed where video modeling was combined with other technologies for improving skills.
Definition and Theoretical Framework for Video Modeling. Video modeling consists of an individual watching a video of himself or herself as a model, or someone else as a model. The model demonstrates a specific task, then the individual imitates the actions viewed on the video (Haring et al., 1987). Video modeling is based on Bandura‘s social learning theory. According to Bandura (1968) most humans learn by watching others. Observational learning is useful because an individual observes another person exhibiting a specific behavior then engages in a similar behavior (Bandura, 1986).
Modeling is a response where an individual observes another person demonstrating a novel behavior, then the observer reproduces the behavior. This model may be in vivo or 40 Stephanie Sokolosky, Texas Tech University, May, 2011 presented using a video (Baer, Peterson, & Sherman, 1967). In observational learning, there are four main components that contribute to its effectiveness: attentional, retentional, production, and motivational (Bandura, 1986). The attentional process refers to the individual‘s ability to attend to the model. The retentional process applies to the participant‘s ability to observe the model and retain the memory of the activity. The production process results in the individual reproducing the modeled behavior. It is critical that the requirements of the behavior be within the learner‘s ability or behavioral repertoire. The last process is motivational. If the person experiences positive incentives from performing the behavior, it is more likely the behavior will become part of the person‘s behavioral reperetoire.
VSM is a specific application of video modeling where the individual observes himself or herself successfully performing a behavior (Dowrick, 1999). A theoretical basis for the effectiveness of VSM is based on Bandura‘s (1977) seminal article on self- efficacy. Self-efficacy is a strategy whereby an individual observes oneself successfully performing a behavior, and this experience contributes to an improved self-image, and becomes valued as a self-belief. An important factor in the use of VSM is that the observer may be more attentive to a self-image than an image of another person as the model. If there is less attention to the model, then the self-efficacy is lessened (Dowrick,
1999).
Video modeling has been successfully used to help children with and without disabilities to learn novel skills (Bandura, Ross, & Ross, 1961; Charlop, Schreibman, &
Tyron, 1983; and, Hosford, 1980). Initially observational learning methods were used with typically developing children, then applied to children with disabilities. Some of the 41 Stephanie Sokolosky, Texas Tech University, May, 2011 skills taught using these methods included the following: motor skills (Labiadh,
Ramanantsoa, & Golomer, 2010); play skills (Mastrangelo, 2009); peer-monitoring training for helping other children with disabilities (Delgado & Greer, 2009); incidental learning during small group instruction (Ledford, Gast, Luscre, & Ayres, 2008); and, life skills and signing (Biederman & Freedman, 2007).
Video Modeling and Children with Autism. Video modeling has been used to help individuals become independent when learning a specific skill or task. Video modeling has been found to be particularly well-suited for individuals with ASD. Quill
(1997) stated that many individuals with ASD were more proficient processing visual information, than auditory or verbal information. For that reason, visual supports provided these individuals with more complete information about their environment
(Heflin & Simpson, 1998). Video modeling has been very useful for individuals with autism because the video is able to direct attention to salient issues, which may be emphasized with narration (Charlop-Christy & Daneshvar, 2003). In addition, the person is able to repeatedly watch the video, providing a consistent model across a variety of instructors (Charlop-Christy et al., 2000). Video modeling has been used successfully to teach a number of skills to individuals with autism. Many individuals with autism rely primarily on visual information to learn from their environment (Dettmer, Simpson,
Myles, & Ganz, 2000), consequently, the use of a video modeling has been identified as an effective method for maximizing a preference for visual learning modality (Corbett,
2003).
The model for the video may be the person receiving the training (self-model), or others may be the model. Both of these have been found to be effective and the nature 42 Stephanie Sokolosky, Texas Tech University, May, 2011 the training contributes to the model selection. The use of others as models has been successful for implementing video modeling for individuals with ASD as well as children and adolescents with other disabilities (Branham, Collins, Schuster, & Kleinert, 1999;
Norman, Collins, & Schuster, 2001). In analyzing the use of another person to model the desired behavior, adults and peers have demonstrated the skill, then the learner imitated the skill that was viewed in the video.
Since the ultimate goal of any educational program is to accomplish the highest level of independence, video modeling may be an efficacious intervention that offers flexibility in the attainment of skills, and the opportunity for generalization through multiple exemplars (Corbett, 2003). This review has included studies addressing the use of video modeling in addressing various deficit skills in young children with autism.
The categories included in this review emphasized social/communication, play skills, then the use of VSM, as it was related to social skills, challenging behavior and perspective taking. Video modeling has also been combined with other interventions, and three studies were included where other technological methods were combined with video modeling for teaching safety skills.
Video Modeling and Social/Communication Skills. Video modeling has been demonstrated as effective for improving social skills. Researchers and practitioners have applied video modeling in a variety of settings with subjects ranging in ages from preschool through adulthood. Initially, the topics covered in this section include the use of video modeling as an intervention method for teaching conversational speech to children with autism (Charlop et al., 2009). Additional uses of video modeling include
43 Stephanie Sokolosky, Texas Tech University, May, 2011 training social interaction initiations (Apple et al., 2005), modeling appropriate toy play
(Nikopoulos & Keenan, 2003), and increased social interactions and reciprocal play
(Nikopoulos & Keenan, 2004). In five studies, the use of video is also combined with other technologies with the goal of improving social skills. Simpson et al. (2004) combined video with computer-based instruction for developing targeted social skills. In two studies, videos were combined with scripted comments for improving communication skills. Finally, two studies (Charlop-Christy et al., 2000; and Gena,
Couloura, & Kymissis, 2005) combined video modeling with in vivo modeling for increasing emotion-based interactions and responses.
Video modeling has been demonstrated as effective for improving social skills.
The ability to initiate and maintain a conversation is essential when establishing social relationships. Individuals with autism struggle with the complexities of reciprocity while participating in a conversation, in order to maintain a verbal exchange (Charlop-Christy
& Kelso, 2003). Charlop et al. (2009) used video modeling to teach conversational speech to children with autism. The specific goal was to expand the variation in conversational speech patterns by systematically assessing the effects of video modeling, and increasing a variety of responses. Another goal was to assess the effects of generalization across persons, settings, and topics of conversations. In addition, the researchers observed unstructured play sessions to determine if there was an increase in question-asking. The two participants were boys with autism, eight and nine years old.
The video, with an adult model, provided specific scripts when playing with six sets of toys. Generalization settings included home with siblings, as well as typically developing
44 Stephanie Sokolosky, Texas Tech University, May, 2011 peers in an outdoor play area. The results for both participants indicated video modeling contributed to increased variation in their conversations.
In a similar study, video modeling was used for teaching the ability to initiate social interactions. Apple et al. (2005) used a multiple baseline across participants research design, with video modeling training that focused on teaching compliment- giving responses and initiations. The explicit instructions for these skills were embedded within a video. The participants were two 5-year-old boys with ASD. Peers served as models in eight separate video segments demonstrating compliment-giving responses, and compliment-giving initiations. The adult participated in the video to insert the targeted rule. In a similar study, Nikopoulos and Keenan (2003) created a video of an adult or peer playing with sets of toys. After viewing the video, the participants, seven children with developmental and learning disabilities, ranging in ages between 9 and 15 years, were provided access to the toys from the video. The researchers measured latency to socialization, and appropriate play with any toy available in the experimental room.
The video model enhanced the social initiation skills of four children, and appropriate play with the toys. In another study by Nikopoulos and Keenan (2004), the participants, three children with autism, observed a video of a typically developing peer participating in reciprocal play with an adult. These participants increased their social interactions and reciprocal play.
In addition to using video modeling as the primary social intervention, other researchers have demonstrated the efficacy of combining video with other technologies.
Simpson et al. (2004) combined video clips with a computer-based program. Other researchers (Charlop & Milstein, 1989; and, Taylor et al., 1999) combined video 45 Stephanie Sokolosky, Texas Tech University, May, 2011 technology with prompts and reinforcers, as well as scripted play comments for improving social skills. Finally, two studies (Charlop-Christy et al., 2000; and, Gena et al., 2005) extended the existing literature to explore the use of video modeling combined with other interventions to improve the social aspects of communication.
Another strategy for improving social skills was the use of video and computer based instruction (Simpson et al., 2004). The researchers used a multiple probe research design using peers without disabilities as the models. The participants were four elementary-aged students with autism. Video clips of the targeted social skills were created by the teacher. The social skills included sharing, following teacher directions, and social greetings. These examples were incorporated into a computer-based program, where the participants viewed the video clips. Following the training, the students were involved in group activities with typically developing peers. Within the natural setting, the students rapidly improved their use of the targeted social skills.
Two studies used video modeling for improving social skills in children with autism where the video highlighted scripted play comments that were modeled between an adult and a child (Charlop & Milstein, 1989; Taylor et al., 1999). In the Charlop and
Milstein (1989) study, three boys with autism viewed a video with two people discussing specific toys. The scripted conversations were instructive in the proper use of the toys.
The children learned the conversational skills, then generalized and demonstrated maintenance over a 15-month period. The researchers used similar video modeling procedures for the first phase of the study. The participants viewed a video of a sibling and adult playing with play materials that were selected, based on participant preferences.
After the scripted comments were practiced, the second phase included a forward 46 Stephanie Sokolosky, Texas Tech University, May, 2011 chaining procedure with a goal of increasing the length of the comments. Video modeling was effective in enhancing the play-based comments with the siblings.
Taylor et al. (1999) combined video modeling with prompts and reinforcers to improve targeted skills, including scripted and unscripted play comments. The participants were two children, six and nine years, who participated in a multiple baseline probe design across activities. In this study, prompts were provided until the correct target behavior was achieved, then reinforced through adult comments. The participants gradually increased their play comments or statements during play activities with their respective sibling playmates.
Another use of video modeling for improving social skills compared video modeling with the use of in vivo interventions. In the first study, Charlop-Christy et al.
(2000) compared the use of video modeling to in vivo modeling with five participants with autism, ages 7-11 years. The social skills were individually selected for each participant and the results were measured using a multiple baseline design across participants. The behaviors were specific for each child and included expressive labeling of emotions, independent play, spontaneous greetings, conversational speech, and some self-help skills. The target behaviors were presented using both video modeling and in vivo modeling, with the result of video modeling leading to a more rapid acquisition of the skills than in vivo. In the second study, Gena et al. (2005) also compared these two methods in the modification of affective behavior of three preschool children with autism, in their ability to show the emotions of sympathy, appreciation and disapproval.
Using multiple baseline across the subjects, in a naturalistic setting (at home), video modeling was combined with reinforcement contingencies to enhance the effectiveness of 47 Stephanie Sokolosky, Texas Tech University, May, 2011 acquisition of appropriate affect using in vivo and video modeling training. The in vivo and video modeling methods were randomly presented to account for order effect.
Pretend play contexts included varied scenarios that were interesting to each child. The results indicated that each participant acquired appropriate affective responding more rapidly during the second intervention phase, whether it was video modeling or in vivo.
The researchers concluded that both methods were effective in improving affective responding.
Social and communication development is an integral component of normal child development (Pizzo and Bruce, 2010). Researchers have demonstrated promising outcomes by using video technology, including video modeling. In addition to social and communication interventions, video modeling has also been found to be effective for improving play skills.
Video Modeling and Play Skills. Social competence encompasses the social skills including social initiations, maintenance of conversation topics, and reciprocity.
When considering social development in children, the context of play is an integral component as the primary natural setting for learning and practicing these social skills
(Wolfberg & Schuler, 1993). In addition to using video modeling for teaching social skills to children, it has also been effective in teaching play skills (D‘Ateno et al., 2003;
MacDonald et al., 2009; Reagon et al., 2006).
Reagon et al. (2006) used a sibling and peers as the models for teaching play skills. The typically developing 7-year-old brother and other typically developing peers from the participant‘s class served as models for the participant, a 4-year-old boy with
48 Stephanie Sokolosky, Texas Tech University, May, 2011 autism. The study replicated the effects of the Taylor et al. (1999) study described in the previous section. The brother and peers modeled four pretend play scenarios with props to support the imaginative experience, such as fireman hat and yellow garden hose. The video included actions and scripted statements. After watching the video, the participant and play partner(s) were instructed to ―Go play‖. The participant learned the play skills and generalized them to new settings with new partners.
In another study with the primary goal of teaching play skills, D‘Ateno et al.
(2003) used video modeling to teach complex play skill sequences to a preschool child with autism. The ultimate goal was to enhance the child‘s ability in using imaginative play skills, since children with autism are frequently limited in their ability to participate in pretend play (Jarrold, 2003). Three video vignettes using an adult model, represented play sequences, including scripted verbal statements and motor movements. A multiple- baseline procedure was applied across the categories of baking, shopping and tea party.
The results indicated an increase in both verbal and motor play responses, however, limited novel responses were noted.
A third play-based study (MacDonald et al. 2009) emphasized an enhanced length of the reciprocal pretend play sequences. Two pairs of children participated in the study, each pair consisting of one child with autism and one typically developing child. There were three play sets for teaching reciprocal pretend play including the use of specific scripts, the demonstration of reciprocal verbal interaction chain, and the use of actions exemplifying the cooperative nature of using the provided play materials. Two adults acted out the sequence, gender-matched with the observer. A multiple probe design across play sets assessed the effects of video modeling. The results of this study 49 Stephanie Sokolosky, Texas Tech University, May, 2011 produced an increased length of reciprocal pretend play between the children with autism and typically developing peers.
Video modeling has been developed as an effective intervention for teaching play skills to children with disabilities. The three studies in this section used video modeling as the primary instruction method for training complex play skills. The models varied, including siblings and peers, and some studied included play materials and props.
Through these structured methods, children with disabilities were able to improve their repertoire of pretend play. Play-based activities have been effective for developing symbolic thinking and language (Hill, 2010).
Video Self-Modeling and Social Skills. VSM is another use of video modeling where the participant acts as the model in the video. Some researchers make the assumption that it is helpful when the model is similar in age, gender, race and other characteristics to oneself (Bandura, 1969; Buggey, Toombs, Gardner, & Cervetti, 1999).
Dowrick (1999) proposed two primary VSM methods with the first identified as positive self-review, and the second was feedforward. The video positive self-review method required a two-step process for producing the video. In the first step, a video was produced where the learner attempted a target skill, including the use of rehearsal or incentives to assure the most favorable video. The second step was the editing phase where the best images were retained, and the learner was shown completing the task at the highest level possible. These fine-tuned examples were the only ones used in this video modeling process. These videos emphasized a behavior that was currently in the learner‘s repertoire but needed strengthening.
50 Stephanie Sokolosky, Texas Tech University, May, 2011
The second VSM subclassification was the use of a feedforward method where the video depicted a skill not yet acquired by the learner. Another use of the feedforward method was one where the learner exhibited a familiar skill in a challenging setting. In this feedforward method, the learner mastered the component skills and video was used to as a mental rehearsal. Usually the components were viewed in a novel sequence or a new setting. Feedforward has been used when the learner had not yet achieved the target behavior, such as an athletic training video (Dowrick, 1999).
Two methods have been used to obtain VSM videos. The first method incorporated three phases: (a) video the subject exhibiting many behaviors including the desired behaviors, (b) edit the video so only the desired behavior remains, and (c) view the video containing only the preferred behavior modeled by the subject (Meharg &
Woltersdorf, 1990). This first method is time-consuming and requires multiple tapings to obtain a desirable exemplar. In the second production method, the learner is video-taped while imitating a correct form of the desired skill. This second method works well with language and social skills and is less time-consuming and less complicated to produce
(Dowrick & Raeburn, 1995; Whitlow & Buggey, 2003).
Several researchers have used VSM method for improving social skills.
Thiemann and Goldstein (2001) used video feedback combined with written text and pictorial cueing to improve social communication. In another study, VSM was used by
Wert and Neisworth (2003) to improve spontaneous requesting in young children with autism.
51 Stephanie Sokolosky, Texas Tech University, May, 2011
In the Thiemann and Goldstein (2001) study, the researchers combined video feedback method with social stories and written text cues to improve social communication in five children with autism. Frequently students with autism have demonstrated a restricted range of social communication skills including deficits in requesting information from others, listening and responding to others, as well as interacting in simple games. The participants in this study combined five children with autism and 10 peers without disabilities. All of the children targeted for intervention had impaired social skills yet demonstrated emerging word identification skills. The participants, who spent a portion of their day in an inclusive classroom, exhibited some functional communication and were able to adequately communicate their wants and needs. Studies indicated that many individuals with autism exhibited specific strengths in their preference to receive information using a visual format. In the sessions, triads, including one individual with autism with two non-disabled peers, participated in the following sequence of events: (a) 10 minutes of systematic instruction incorporating a social story with written text cue rehearsal and role play, (b) a social activity, and (c) a self-evaluation using video feedback by viewing a video of the session. The clinical goals included contingent responding, obtaining attention, initiating comments, as well as initiating requests. The results indicated increases in targeted skills and provided support for the use of visual methods for improving social skills in young children with autism in social settings with non-disabled peers.
In another VSM study, Wert and Neisworth (2003) incorporated VSM for teaching new skills and improving existing skills in young children with autism. The participants were four preschool children, 3-6 years old, with a target behavior of 52 Stephanie Sokolosky, Texas Tech University, May, 2011 spontaneous requesting. A video feedforward method was used where each child had a unique video of himself demonstrating the desired request behaviors. The VSM tapes were created from taped play sessions using discrete trial drills modeled after the Teach
Me Language manual (Freeman & Dake, 1996), followed by the child viewing the video of the session. The results demonstrated a marked increase in spontaneous request behaviors in three of the four participants. The fourth participant did not demonstrate an interest in the video viewing, and even though there was an increase in the targeted behavior, the other three participants demonstrated a higher level of improvement.
In summary, video modeling has been used for social skill development with promising outcomes. The use of video modeling, combined with other interventions, as well as video self-modeling offer a wide range of opportunities for developing interventions. As technology continues to improve, the opportunities for new interventions will increase.
Video-Self Modeling and Challenging Behaviors. In addition to the use of video VSM for improving social skills, Buggey (2005) used VSM in addressing challenging behaviors to address social initiations, response to questions and problem behavior. The participants in both Buggey studies attended a small private school serving children with autism. The research combined three separate studies into one publication.
In the first study, Buggey used VSM with the combined purpose of decreasing pushing behavior while increasing social initiations. Buggey applied the feedforward method of
VSM in training students with ASD to increase a variety of behaviors including language and social interactions, with a decrease in tantrums and aggression. A multiple baseline design across students and behaviors provided the structure for evaluating the results. 53 Stephanie Sokolosky, Texas Tech University, May, 2011
The participants ranged in ages from 5 to 11 years, exhibiting a range of autism-related behaviors. The first study targeted the social initiation portion of the study which included two children, 9 and 11 years old. The students modeled a three-minute video where the video model demonstrated typical positive social interactions, with a favorable ending image and an overlay of reinforcing words such as, ―Great job, Tommy.‖ The videos were viewed with the teacher preceding school. The findings suggested improvements for both participants in terms of improved quality and quantity of spontaneous interaction with each other, as well as other students in the school. In the second Buggey study, video modeling improved challenging behaviors in two children six and eight years old, who used VSM to improve tantrum behaviors. The students, along with classmates, acted out situations that frequently resulted in tantrum behavior.
The desired behavior was described to the participants, encouraging polite and friendly interactions. After the participants viewed the film, the duration of the tantrum decreased from 19.3 minutes at baseline to 4 minutes during intervention, and 2.3 minutes during maintenance.
In the third study using VSM as an intervention for challenging behavior, Buggey
(2005) addressed a five year old boy‘s pushing behavior that was usually paired disruptive vocalizations. Since the participant was unable to follow directions to exhibit desired behavior, all of his behavior was taped for three days, resulting in 2 ½ minutes of useful examples of alternative and appropriate behavior. The researchers used frame-by- frame editing to extract single words from the video to serve as a language model.
Sentences were constructed from these words, such as, ―I drink juice.‖ The results yielded an immediate decrease in pushing behavior, which continued through 54 Stephanie Sokolosky, Texas Tech University, May, 2011 maintenance. The language intervention was not as dramatic, yet the student became more responsive at school and home, and used a more extensive spoken vocabulary. The overall results of the Buggey studies were that all of the behaviors improved with the use of video modeling.
VSM is a method that is available to practitioners for improving behaviors, as well as improving social and communication skills. However, there is limited evidence supporting the effectiveness of VSM as an intervention strategy (Shukla-Mehta, Miller,
& Callahan, 2010).
Point of View Modeling (PVM). The use of video modeling in the context of perspective-taking interventions is also referred to as point of view modeling (PVM).
Perspective-taking refers to the ability to anticipate or understand the mental state of others with the goal of predicting another person‘s behavior. This is a skill that emerges in typically developing preschool-aged children (Baron-Cohen, Leslie, & Frith, 1985).
By age 2, children understand that other people have ideas, thoughts and feelings that may differ from their own (Gopnik & Slaughter, 1991). However, in children with autism, this ability is often delayed or absent and they are unable to attribute mental states to themselves or others (Baron-Cohen, 1989). In the area of autism research, video modeling is one method that has been used to explore the concept of the ability of individuals with autism to understand that other individuals may have points of view that may differ from the individual with autism. PVM is an antecedent intervention that incorporates videotaping components of the environment or a specific task, emphasizing the subject‘s vantage point (Shukla et al., 2010). In two studies, PVM was used to teach
55 Stephanie Sokolosky, Texas Tech University, May, 2011 tasks or assess perspective-taking skills (Charlop-Christy & Daneshvar, 2003; Hine &
Wolery, 2006).
In the first PVM study, Charlop-Christy and Daneshvar (2003) studied three boys with autism, six to nine years old, who participated in a multiple baseline design across children and within-child across tasks. Perspective-taking tasks were used in the experiment, similar to Baron-Cohen‘s et al. (1985) ―Sally-Anne task‖. This activity has been used as an assessment to determine if a person was able to demonstrate an understanding whether a doll (Anne) believed that a marble was located where Sally last left it. This was described as a false-belief. The child was asked, ―Where will Sally look for the marble?‖ The child passed the test if they indicated that the marble had been moved and was in a new location because the doll (Anne) had moved the marble. The assessment used for this study was similar to the ―Sally-Anne task‖. Barney™ and Bugs
Bunny™ played hide-and-seek with M & M‘s™. There were five similar perspective- taking tasks in the study. Videotapes were used to train the children with correct responses. The Barney™ and Bugs Bunny ™ task was used for a pretest and posttest, thus was not included in the training. Following the pretest, each child observed the video, then was presented with the task. The results of this study indicated that PVM was an effective method for teaching perspective-taking to children with autism when using this assessment task.
In the second PVM study, Hine and Wolery (2006) taught play-related skills to preschool children with autism. The participants in the study were two girls with autism, ages 30 and 43 months. The materials were displayed in sensory bins, since the children accessed the bins in their classroom and they were free to use the materials in a non- 56 Stephanie Sokolosky, Texas Tech University, May, 2011 directed fashion. In the video clips, adult hands were performing the desired actions with the toys. The video simulated the child‘s visual perspective when playing with the toys.
A multiple-probe design across two behaviors and across two participants was used to evaluate the effectiveness of the video modeling method. The treatment consisted of three components: a daily probe of the target behavior, video modeling of the behavior and daily practice. Each probe resulted in verbal praise and tangible rewards for participation. The targeted tasks included gardening and cooking. Reinforcement was available for using targeted materials, not for imitating the targeted actions. In addition, the researchers used two minutes of preferred cartoons to precede the video clips to help the children attend to the laptop screen. The materials were adapted when one of the participants became satiated. The results indicated that video modeling was effective in teaching these participants specific ways to play with the materials. In addition, these skills generalized to untrained materials for gardening, but not for cooking.
PVM may also be useful for children with autism in learning functional play with toys. PVM could be considered a promising intervention, however further research is needed for it to be considered an effective intervention (Shukla et al., 2010).
Video Modeling Combined with Other Interventions. Video modeling as a single intervention has been described in the previous examples. Additionally, video modeling has been effectively combined with other interventions. Video modeling and video feedback were combined in Maione and Mirenda‘s (2006) study to enhance social skills in a child with autism. Murzynski and Bourret (2007) combined video modeling with least-to-most prompting in self-help training. Gast and Wolery (1988) also combined video modeling with prompting. In the Simpson et al. (2004) study, the videos 57 Stephanie Sokolosky, Texas Tech University, May, 2011 used as models were embedded in computer-based instruction for improving social skills.
In another study combining video modeling with other interventions, Reeve, Reeve,
Townsend, and Poulson (2007) identified positive social helping behaviors using multiple exemplars and multicomponent training procedures.
In the first study, Maione and Mirenda (2006) explored the use of video modeling and video feedback for teaching a child with autism verbal social interaction skills, while the child participated in a peer activity group. The purpose of the study was to increase the total number of verbalizations by the participant and the frequency of initiations and responses. The adult model demonstrated both scripted and unscripted initiations and responses, with multiple exemplars. There were three sets of play materials, and each set was modeled in three videos, totaling nine videos. In each video two adults modeled the desired play behaviors paired with short phrases. Each vignette represented different language exemplars to demonstrate flexibility and variety, but contained the same number of initiations and responses. The modeled language skills were already in the participant‘s repertoire. A multiple baseline design across three play activities was used to determine the effectiveness of the interventions. In addition to the video modeling, video feedback and prompting were added for one of the play activities. The researchers reported an increase in both scripted and unscripted language, as well as improvements in both responses and initiations. Consequently, video modeling was combined with video feedback and was effective for teaching language usage during peer play activities.
The second study combining video modeling with another intervention was conducted by Murzynski and Bourret (2007) where video modeling was combined with least-to-most prompting in training two boys, ages eight and nine, with developmental 58 Stephanie Sokolosky, Texas Tech University, May, 2011 disabilities. The tasks included shirt-folding, pant-folding, sandwich-making and juice- making. The model, a familiar adult, demonstrated each task. The shirt and pant-folding had six steps, whereas the sandwich and juice-making consisted of 10 steps. The participants learned the tasks using the combination of video modeling and prompting.
In a third study combining video modeling with prompting, Gast & Wolery
(1988) compared the effectiveness of video modeling plus least-to-most prompting and least-to-most prompting alone when training the behavior chains. A multiple-baseline across responses and participants in a parallel treatment design, was used to compare the interventions. In both conditions, reinforcement praise and a preferred edible were provided upon completion of each trial. The results indicated that the trials combining video modeling with least-to-most prompting provided mastery in fewer trials than the prompting alone. Consequently, the results of this study suggested that a combined intervention was more effective than the least-to-most prompting alone.
In the final study where video modeling was combined with other interventions,
Simpson et al. (2004) studied the effects of combining video with computer-based instruction. Using a multiple probe design across behaviors, video clips of examples and non-examples of social skills were embedded in a computer-based instruction. The social skills included sharing, complying with teacher directions, and social greetings. Four students, five and six years old, participated in the study, where the video models were typical peers in naturally-occurring situations. The computer-based instruction program presented a definition of the target behaviors, an opportunity to view the video model then respond to questions about the social behaviors. Three out of the four students
59 Stephanie Sokolosky, Texas Tech University, May, 2011 increased in their unprompted social skills engagement, increasing the frequency of behaviors already in the students‘ behavioral repertoire.
In the three studies exemplifying combining video modeling with other intervention components, it is difficult to evaluate the effectiveness of video modeling as an isolated intervention (Shukla et al., 2010). In order to compare similar interventions, specific components would need to be evaluated.
Using Technological Methods for Teaching Safety. Teaching a safety skill to young children with disabilities is the main purpose of the current research. In three studies, safety skills were taught to individuals with autism and developmental disabilities using technological methods. Self, Scudder, Weheba, and Crumrine (2007) used a virtual reality method to take advantage of the strength in many individuals with autism who prefer to learn through the visual modality. Mechling et al. (2009) used video modeling to teach adults with moderate intellectual disabilities three safety skills for extinguishing fires. In a third study, Branham et al. (1999) taught community skills to children with moderate disabilities, including safety in street crossing.
In the Self et al. (2007) study, eight children with ASD participated in a virtual reality training program to learn fire and tornado safety skills. The participants were randomly assigned to receive either the virtual reality training or the integrated/visual treatment model, and the results of the two methods were compared. In Condition 1, the control condition used a variety of visual learning strategies including social stories, picture cards, role-play/rehearsal, visually structured directions, mini work systems and comic strip conversations. In Condition 2, the participants used a virtual reality system
60 Stephanie Sokolosky, Texas Tech University, May, 2011 presented on a laptop. The results of the fire safety training varied and all participants recognized the need for action, and all required prompting during the exiting process.
For the tornado safety training, the Condition 1 participants completed the tornado drill without the need for adult assistance in moving to the safe room. The Condition 2 virtual reality participants required prompting when moving to the safe room. The authors reported that Condition 1 participants practiced the safety skill in a familiar environment, whereas the Condition 2 participants were learning and practicing in a modeled environment viewed in the laptop. However, another consideration was that virtual reality training offered opportunities for individuals with autism to practice safety skills in a safe environment.
In a second study (Mechling et al., 2009) using technology for safety training, video modeling was used for teaching three adults with moderate disabilities the safety skill of extinguishing cooking-related fires. The setting for the training was within a school program at an apartment for teaching home living instruction. A multiple probe design across behaviors was replicated with three students to determine the effectiveness of the interventions. The students were taught to extinguish fires using a fire extinguisher, a lid for a pan, and flour. Video prompting was used in this study was as a priming tool, teaching a skill for potential future events. The results suggested that the use of the fire extinguisher was immediately mastered using video modeling, then generalized to novel settings.
In the third technology-based safety study, Branham and colleagues (1999) used constant time delay combined with other interventions, including video modeling, for teaching three secondary students the community skills of mailing a letter, cashing a 61 Stephanie Sokolosky, Texas Tech University, May, 2011 check and the safety skill of crossing a street. The instructional formats included (a) classroom simulation plus community-based instruction, (b) videotape modeling plus community-based instruction, and (c) classroom simulation plus videotape modeling. A multiple probe design evaluated the generalization to novel community settings. All of the instructional strategies were effective and the skills generalized to the community settings. The researcher did not isolate the effectiveness of video modeling, consequently it is impossible to explicitly attribute the success of the training to video modeling.
The three studies included in this section exemplify the use of video methods for teaching safety skills to participants including children and adults. However, with the limited research in teaching safety skills using video modeling, there has not been a systematic study using video modeling for teaching a young child a safety skill. Safety is an ongoing concern for all individuals with developmental disabilities, including autism, however it is difficult to maintain a safe environment while teaching a safety skill.
Consequently, there is a dearth of research on this important topic. The purpose of this study was to explore the effectiveness of using video modeling to teach young children the safety skill of noticing the yellow plastic markers used to denote a wet area on the floor. The researcher used video modeling for teaching the student to notice the marker and either slow down or stop, then walk around the marker for the purpose of avoiding an accidental fall on a wet area.
Pilot Study
Sokolosky (2010) conducted a study where three children with autism, ages five to six years, used video modeling to learn the safety skill of noticing a plastic yellow marker on the floor, indicating the location of a wet area. The purpose was for the 62 Stephanie Sokolosky, Texas Tech University, May, 2011 children in the study to indicate that they noticed the marker, such as stopping or slowing down, then walked around the marker. The results indicated that the subjects were able to learn the safety skill using video modeling as the training method. However, due to the small number of subjects, the results were not robust. Thus, another study was needed to evaluate the effectiveness of using video modeling to teach young children the skill safely walking around the marker.
Research Questions
The research questions for this study are:
1. Is video modeling an effective method for teaching the safety skill to children
with developmental disabilities and autism?
2. Will the safety skill learned through video modeling generalize across
settings?
63 Stephanie Sokolosky, Texas Tech University, May, 2011
Chapter III Methods
The purpose of this study was to evaluate the use of video modeling to teach a safety skill to five young children with developmental disabilities including autism. In this safety study, the participants walked down the hall in a public school, where they saw a yellow plastic safety marker used to indicate the location of a wet area. However, for the purposes of this study, the floor was not actually wet. The goal of the program was to train the participants using video modeling to notice the yellow safety marker in public locations and walk slowly or stop, then safely walk around the marker. In addition to determining the effectiveness of using video modeling for this safety-training program, generalization across novel settings was also assessed. This chapter describes the participants, setting, materials, variables, procedures, interobserver agreement, procedural integrity, treatment acceptability, and data analysis.
Participants
Selection Criteria. Five young children with developmental disabilities including
autism were selected for this study. The following selection criteria were used for study participants:
1. Children between the ages of 4 to 8 years
2. Lack of knowledge about the safety concerns when a yellow safety marker
was on the floor or outdoors in a public setting
3. No previous exposure to safety training using a video modeling method or
other safety training procedure.
64 Stephanie Sokolosky, Texas Tech University, May, 2011
4. Ability to attend to a video
5. A diagnosis of a developmental disability which may include autism
6. No specific sensory disabilities, such as blindness or deafness
7. No physical disabilities that would inhibit ability to walk independently
Procedure for participant selection. The participants were selected from a
Preschool Program for Children with Disabilities (PPCD) located in an elementary school in the West Texas area. Although only children with developmental disabilities were included in this program, the class spent a minimum of 1 ½ hours daily with typically developing peers in inclusive settings. The names used in this document were pseudonyms to protect the identity of the participants and their families.
Brad. Brad was 5 years old, an African-American male, residing with grandparents. Brad was diagnosed with a developmental disability and was referred by a physician to the public school program. Brad was very cooperative at home and with the school staff, and demonstrated social skills commensurate for his age and cognitive ability. His primary communication method was verbal and he was able to express his needs and wants. Brad exhibited some unique sensory qualities, and frequently extended his tongue beyond the teeth, and lightly chewed on his tongue. This behavior sometimes made it difficult to understand Brad‘s verbalizations. He also periodically twisted his ear, which interrupted his ability to concentrate on a task. Neither of these sensory-related behaviors was serious and did not cause any harm to the student.
Jerry. Jerry was a 5 year old male at the beginning of the study. He was an
African American student who lived with his biological parents. He was diagnosed with
65 Stephanie Sokolosky, Texas Tech University, May, 2011 autism, attention deficit hyperactivity disorder (ADHD), and developmental disabilities by a physician, and Jerry was prescribed a medication for ADHD, Intuniv. During the study, the parent sought medical advice in an attempt to adjust Jerry‘s medication, because he was frequently tired in the morning, and sometimes slept upon arrival at school. By the conclusion of the study, Jerry‘s stamina was noticeably improved. Jerry‘s verbal communication was very quiet he exhibited limited spontaneous initiation of verbal interaction with peers. During group time, he usually required specific prompting by the teacher for group participation. Jerry enjoyed pleasing the teacher and seldom exhibited disruptive behavior.
Jim. Jim was a 5 years old male at the beginning of the study. He was an
African-American student, and lived with his biological parents. As an infant, he was diagnosed with a developmental disability by a physician. He communicated very clearly using oral language. He enjoyed demonstrating leadership skills both within the special education classroom, and in the inclusive settings with typically developing peers. Jim was very active, and enjoyed the opportunities to interact with classmates as well as other students in the school. Jim sometimes required reminders to follow teacher directives
Monte. Monte was a 5 year old male when the study began. Monte was a
Hispanic student who lived with his parents and a sibling. A public school assessment team diagnosed Monte with autism. Monte used verbal communication methods for expressing his needs and wants. Monte was playful and enjoyed interacting with peers in structured and unstructured settings. He appeared to exhibit behaviors for the purpose of gaining attention from the teachers and classmates, as well as students outside the classroom. 66 Stephanie Sokolosky, Texas Tech University, May, 2011
Richard. Richard was a 5 year-old male, diagnosed with autism by a physician.
Richard was Hispanic and resided with his biological family, who were primarily
Spanish-speaking. Richard received services from a bilingual teacher for 30 minutes, five days a week. Improvement in Richard‘s English communication was noticeable from the beginning of the study to its conclusion. Instruction in Richard‘s class and other school settings were provided in English. Richard had adequate receptive language abilities and demonstrated the ability to understand directives provided in English. At school he was encouraged to use English words to get his needs met. By the conclusion of the study, Richard increased his spontaneous peer interactions and initiated play with classmates.
Settings
The training sessions were conducted in the hall of a public elementary school since this was a natural location for the use of yellow safety markers. The hall was approximately 10 feet wide. The time established for the training was determined by convenience for the class as a whole, as well as each study participant, and at a time when it was unlikely the hall would be crowded. During the training sessions, the participant, teacher who provided the intervention, and researcher were present. The hall adjacent to the special education classroom was the location for the baseline and intervention sessions. The generalization sessions were carried out in another location in the building.
Trainers/Interventionists
The principal interventionists (referenced as teachers) included the classroom teacher and either instructional aide assigned to the PPCD classroom. The teachers 67 Stephanie Sokolosky, Texas Tech University, May, 2011 received training on the following topics: (a) video-modeling overview, (b) prompting and reinforcement, and (c) technical training on the operation of the video-viewing player used during intervention. For each topic, training was provided for 10 to 15 minutes.
The researcher asked pertinent open-ended questions and provided the teachers with the opportunity to participate in a dialogue to ensure understanding. The teacher practiced operating the video player until mastery was achieved. The researcher independently determined whether the teacher was conducting the intervention with fidelity by reviewing the intervention videos on a daily basis and providing feedback to the teacher on program fidelity. The teacher viewed the video prior to a discussion between the researcher and teacher on the needed improvements. The researcher emphasized consistent use of verbal cues across participants, limiting reinforcement statements to acknowledgement of walking down the hall, and refraining from error correction.
All data were collected by the researcher. The videotapes that were selected for procedural integrity and inter-observer agreement were reviewed by a PPCD teacher who was familiar with the data collection procedures and was a special education graduate student. This independent observer worked in another PPCD classroom similar to the classroom from which the participants were selected and was involved with the pilot study conducted by the researcher during the previous academic year. With a clear understanding of the research goals, her analysis was accurate.
Materials
In this study, technological equipment for viewing and recording a video was required. The materials used for this study included the video camera with rechargeable batteries; equipment for viewing the video; Sony DVD-R mini discs; computer software 68 Stephanie Sokolosky, Texas Tech University, May, 2011
(Sony Picture Utility) to transfer video data to a DVD; and a computer with the capability and memory to support the video software. The video camera was a Sony HDR-UX5.
The video viewing equipment was a Phillips DCP815, which was portable and hand-held with a screen approximately 8.5 TFC LCD. It had a rechargeable battery so its use was not restricted to a location with proximity to an electrical outlet. Each teacher was trained to operate the video viewing equipment used during the intervention sessions.
In addition to the technical equipment, yellow plastic safety markers were used to mark the location of the potentially wet area. There were two markers, and each was 26 inches tall and 11 inches wide, with the word ―Caution‖ prominently displayed, and a line drawing of a person who looked like he was falling. The yellow marker consisted of two pieces of plastic, connected at the top, and separated to stand on the floor. The markers were consistently placed 6 feet from the classroom door, 10 feet apart, and 1 foot away from the wall.
Prior to the study, a training video of the classroom teacher modeling the appropriate behavior was created. In this video the plastic markers were placed in the hall precisely as they were placed for the training sessions. As the teacher walked down the hall in the video, the researcher narrated the tasks performed by the teacher and identified in the task analysis. The narration included the following: ―When you are walking down the hall and see a yellow marker, stop or slow down; go around it; keep walking; yellow marker (indicating the second yellow marker); stop of slow down; go around it; keep walking.‖ As the teacher walked down the hall, and stopped or slowed down upon approaching the two yellow markers, the narration reflected those tasks. This video was shown to each student during the intervention phase of the study, and served as the video 69 Stephanie Sokolosky, Texas Tech University, May, 2011 model. The video was approximately 2 minutes long. In taping the video model, the session was carefully staged so there were no distracters in the hall (i.e., children talking and walking down the hall), and the discrete components of the behaviors to be modeled
(i.e., walking down the hall, stopping at the markers, and walking around the markers) were clearly represented in the video. The location at which the model video was created was precisely the same location at which the intervention sessions took place.
During the intervention sessions, in the hall a light weight chair was placed 1 foot from the classroom door. The teacher sat in the chair with the student standing in front of her, with the student‘s back located next to the teacher‘s legs. The teacher held the video-viewing equipment in front of the student while the student watched the model video.
Dependent Variables and Measurement
The dependent variable consisted of the number of tasks that the student correctly modeled from the video and were listed on the task analysis. The correctly modeled tasks were represented in a percentage of the total number of correct tasks based on the task analysis of the entire procedure (see Appendix A). The percentage of correct tasks completed was calculated by summing the correct tasks completed and dividing by the maximum total correct tasks and multiplying the calculated number by 100. To reach the criterion, each participant completed 80% of the tasks correctly, and maintained this level for a minimum of three consecutive sessions during the intervention phase. After the participant reached the criterion, the generalization probes were collected. A response was correct when the student performed the task without error, consistent with the visual and auditory model from the video. The student was not expected to vocalize the 70 Stephanie Sokolosky, Texas Tech University, May, 2011 narration of the video, only model the behaviors demonstrated in the video. The response was incorrect if the participant did not perform the task consistent with the video model.
For example a response in which the participant ran past the yellow plastic safety marker without slowing down or stopping, was coded as an incorrect response. Also, during the generalization phase, data were collected on the percentage of correct tasks repeated in a novel setting with no video model.
Independent Variable/Intervention
The independent variable is the presentation of the video model of the teacher to each participant. The video model included a narration of the correct tasks, such as walking down the hall, stopping, and walking around the markers. In developing the video, the teacher (modeling the desired behavior) and researcher (filming the video) edited the video to clearly represent the correct behavior when safely walking around the yellow safety markers. In addition to attending to the visual representation, a clear, concise narration was provided and the participants attended to the visual and auditory input from the video. More detailed information on the intervention is described under the procedure section.
Experimental Design
An AB design with generalization (Alberto & Troutman, 2009) across participants and settings was used to evaluate the effectiveness of using the video modeling. During baseline, each student was assessed for his ability to walk down the hall where the yellow safety markers were located, based on the number of correct tasks completed. During the intervention phase, the student first viewed the video model, then the teacher directed the student to imitate the model. Following the student‘s completion 71 Stephanie Sokolosky, Texas Tech University, May, 2011 of walking down the hall, the teacher provided a simple reinforcing statement for completing the directive of walking down the hall (e.g.., ―Brad, thank you for walking down the hall‖). After the first student demonstrated the ability to imitate the behavior observed in the video of walking around the yellow safety markers with 80% or more accuracy, for three consecutive sessions, the other students began the process. As in any
AB design, skill levels at baseline and intervention phases were compared. A comparison across students was documented by noting the changes in the percentage of completed correct tasks from the task analysis list. Generalization probes followed the intervention sessions and the generalization results were compared to the baseline and intervention phases.
Procedure
After obtaining approval for the study from the Texas Tech University
Institutional Review Board (IRB) (Appendix B), an invitation to participate (see
Appendix C) was made at the South Plains Autism Network (SPAN) meeting and parent contacts through the Burkhart Center for Autism Education and Research at Texas Tech
University. Written approval for the study was obtained from the local school district
(Appendix D) by meeting with the executive director for Research, Assessment &
Accountability. Following the district approval process, principals and teachers were contacted through the local school district to invite their participation in the study.
Upon selection of the participants, parents received a written consent form which explained the participant criteria, purpose of the study, and timeline of the study. Parents also met with the researcher to discuss the study and voice their concerns and questions.
After the researcher addressed their concerns and answered their questions regarding the 72 Stephanie Sokolosky, Texas Tech University, May, 2011 intervention and procedures, an informed consent (see Appendix E) was signed, with parents receiving one copy and the other copy was secured the university office of the chair of the dissertation committee, and locked in a file cabinet. A Spanish version of the parental informed consent was also available (Appendix F) for the parent whose primary language was Spanish.
The classroom teacher completed a written consent (see Appendix G) that explained the participant criteria, purpose of the study, and timeline of the study. An appointment with the teacher was scheduled at which the researcher discussed the details of the study that included: (a) identification of teachers helping with the study, (b) preferred day and time for intervention, and (c) potential barriers such as inconvenient times for intervention.
Prior to training, the researcher met with parents and teachers. During the parent orientation meeting, parents were briefed on the procedures involved in the video modeling intervention, and provided with an opportunity to ask questions. The parents completed the Child Personal Data Form (see Appendix H). The orientation for the teachers provided an opportunity for training in the following topics: (a) technical training on the use of the video player, (b) overview of video modeling, and (c) consistent use of prompting and reinforcement (Appendix I). The precise prompts and reinforcing comments were selected for use throughout all phases for all participants. The study included the following phases: (a) baseline, (b) intervention, and (c) generalization.
The teacher was videotaped for the video model used in the study. The correct tasks were clearly exemplified in the video and the narration of the correct tasks was
73 Stephanie Sokolosky, Texas Tech University, May, 2011 carefully designed. The wording was specifically selected to match the comprehension level of the student and to clarify the discrete tasks. The researcher spent approximately two hours developing the video model, downloading it to the computer, then burning a
DVD that was used in the study.
Baseline
During baseline, the teacher asked the student to walk down the hall in which the yellow markers were placed. The researcher documented the number of correct tasks completed by the participant. After the student completed walking down the hall, he was verbally reinforced for cooperating with the request of walking down the hall.
Intervention
During the intervention phase, the teacher and the student were located in the hall approximately 5 feet from the yellow markers. The teacher was seated and held the video player, then the student was provided a simple directive (e.g., ―Jerry, watch the video‖).
Upon completion of viewing the video one time, the student was directed to walk down the hall where the student would see the yellow markers. The prompt provided to the student was: ―Walk down the hall like Ms. Smith‖. After the student completed the task of walking down the hall past the two yellow markers, the teacher provided a simple verbal reinforcement for completing the task, with no error correction nor reinforcement for successful completion. A task performed incorrectly was ignored, and the student received the same social reinforcement for completion of the task (e.g., ―Monte, good job walking down the hall.‖). In this way, the learning was dependent on observing the video and imitating the steps viewed in the video, and not dependent on reinforcement. The unique element included in the intervention was viewing the video as a model for the 74 Stephanie Sokolosky, Texas Tech University, May, 2011 correct tasks of safely walking around the markers. No video model was provided during the generalization phase. Each training session lasted approximately 5 minutes. The training video was 2 minutes in length and it took the participant approximately 1-2 minutes to walk down the hall.
Generalization
The purpose of the generalization phase was to determine if the participant was able to perform the acquired skill in another setting. Generalization probes were conducted after mastery during the intervention phase, beginning one week following completion of intervention, and concluding one month following intervention. The generalization phase was conducted in the same school, but a novel location was determined based on the specific day selected for generalization and the location of other groups of students in the school. During the generalization phase, the markers were placed 10 feet apart, and the student was brought to that area and told, ―Walk down the hall‖. The video model was not provided during the generalization phase. When the student completed the tasks of walking down the hall and navigating the yellow markers, the student was told, ―Thank you for walking down the hall.‖ The percent correct tasks completed was calculated in the same manner used during baseline. The student did not receive any additional prompting or reinforcement for success. Data was collected and recorded, as in the intervention phase, for a minimum of three sessions.
Interobserver Agreement
The researcher coded the dependent variable (correct tasks completed) in all of the sessions using a data collection form (see Appendix J). Another independent observer coded the dependent variables (correct tasks completed) for 38% of all sessions 75 Stephanie Sokolosky, Texas Tech University, May, 2011
(baseline, intervention, and generalization) using a data collection form for the independent observer (see Appendix K). Prior to data collection, the independent observer viewed the video model and reviewed the rating forms. The video of the participant completing the tasks modeled from the video were scored based on the behavior observed in the model video. A training session was provided for the observer with an opportunity to practice the data recording procedures. During the sessions, the independent observer recorded the student‘s tasks completed as modeled in the video.
This data was compared to the data collected by the researcher. An agreement was counted when the researcher and the independent observer recorded the same response for each task. A disagreement was defined as a discrepancy between the scoring of the independent observer and the researcher. Percentage agreement was calculated at the end of each observation session using the following formula: [agreements / (agreements + disagreements)] x 100. The interobserver agreement data was summarized for the five students. The researcher coded 100% of the sessions, and the observer coded a mean of
38% of all of the sessions, ranging from 34% to 47% of the sessions for each participant.
Percentage agreement for all five participants was found to be: baseline (100%), intervention (94%), and, generalization (100%). The range of agreement scores for all of the intervention sessions was 75% to 100%. This high level of agreement substantiates the credibility of the findings.
Procedural Integrity
Procedural integrity is the extent to which an independent variable is applied as planned and described. In addition, other unplanned variables that may have presented confounding results were also noted (Cooper, Heron, Heward, 2007). Procedural 76 Stephanie Sokolosky, Texas Tech University, May, 2011 integrity was important because it represented the extent to which the independent variable was implemented. To obtain procedural integrity, the trained independent observer collected data on 33% of the baseline and generalization sessions, as well as
47% of the intervention sessions. The trained independent observer completed a data collection form for procedural integrity (see Appendix L). This form listed seven tasks including setting up the markers, and prompting the student to walk down the hall. ―Yes‖ was recorded for correct implementation of the task; ―No‖ was recorded for an incorrect implementation of the task. A percentage was calculated by dividing the sum of ―Yes‖ responses by the total of ―Yes‖ and ―No‖ responses. The overall procedural integrity scores for all of the sessions across participants was a mean of 97% with a range of 95% to 100%. The teachers conscientiously applied the intervention with a high level of procedural integrity across participants. High procedural integrity ratings confirm that the independent variable (video model intervention) was implemented as planned.
Treatment Acceptability
Treatment acceptability refers to the extent to which target behaviors were appropriate, and whether intervention procedures were acceptable (Cooper, Heron, &
Heward, 2007). In addition, treatment acceptability determines whether changes to the target and possibly collateral behaviors were important and significant. Treatment acceptability was calculated using the Intervention Rating Profile (IRP-15; Witt & Elliott,
1985), a 15-item questionnaire using a Likert-type scale. Treatment acceptability percentages for the responses for each participant were calculated using the following formula: sum the item responses for each rating category (i.e., agree or strongly agree), divide the results from each rating category by the total number of items (15), then 77 Stephanie Sokolosky, Texas Tech University, May, 2011 multiply by 100 to provide a percentage. The classroom teacher and instructional aides completed one form (Appendix M), and the parents completed a similar form, adapted for parent-related statements (see Appendix N). A treatment acceptability form was available in Spanish (see Appendix O). The responses from the teachers and parents were compared, and provided the researchers with the groups‘ insights about whether the treatment was acceptable and effective. Questions included the following: (a) I would suggest this intervention to other teachers or families, (b) I liked the procedures used in this intervention, and (c) I would be willing to use this intervention in the school or home setting.
Data Analysis
Data from the study were analyzed using a visual analysis method. Graphic displays of data were the primary vehicle for interpreting and analyzing treatment effects in this single subject research study (Lo & Starling, 2009). Graphs were used to visually present data of the percentage of correct tasks completed for baseline, intervention and generalization. Level, trend, and variability were described and compared across phases.
Inferences were based on the percentage of improvement assessed within and between the participants. Treatment acceptability was based on the Likert-scale ratings, and the parent and teacher responses.
78 Stephanie Sokolosky, Texas Tech University, May, 2011
Chapter IV Results
This study examined whether video modeling was an effective method for teaching a safety skill (walking around a yellow safety marker) to young children with developmental disabilities, including autism. In this chapter, the data are presented and analyzed for the baseline, intervention, and generalization phases for the five participants.
Individual performances are presented in terms of the percentage of correct tasks completed after viewing the video model. The generalization data were collected using three probes for each student. The results for all of the children are discussed and graphically represented in Figures 1 through 5. The results correspond to the research questions for this study: (a) Is video modeling an effective method for teaching children with developmental disabilities and autism the safety skill of walking around yellow markers that indicate a wet area? and, (b) Will the safety skill learned through video modeling generalize across settings? The results for each student are presented separately. An overall summary for all participants is provided.
Participants
Brad. Brad was selected as the first participant to begin the intervention phase because his baseline data showed a stable level (see Figure 1). During baseline, the percentage of correct tasks completed was 48%. During intervention the overall mean percentage of correct tasks completed was 73%, with an increasing trend and level. Brad reached criterion in 16 sessions. During intervention sessions 10, 11, and 12 there were large numbers of students in the hall and Brad became distracted. In intervention session
12, he also exhibited the behaviors of lightly chewing on his tongue and bending his ear, 79 Stephanie Sokolosky, Texas Tech University, May, 2011 which appeared to have distracted his attention to the video modeled tasks. Based on
Brad‘s demonstration of 100% correct tasks completed in intervention sessions 10, 14,
15, and 16, the inference could be drawn that Brad was able to learn the skill due to the video modeling intervention. The increase in the trend and level during intervention exemplify the possible effectiveness of the intervention. For the generalization phase,
Brad‘s percentage of correct tasks completed was 95%. This exemplifies Brad‘s ability to recall the correct tasks for safely walking around the yellow markers. In summary,
Brad learned the safety skill through video modeling and demonstrated his ability to generalize this skill in novel locations.
Figure 1. Brad‘s performance during the baseline, intervention, and
generalization phases
Baseline Intervention Generalization
actions
Percentage of correct Percentage
Sessions
Jerry. Figure 2 shows the results of Jerry‘s performance during baseline, intervention, and generalization phases. Jerry‘s percentage correct tasks completed for baseline was 34%. Jerry achieved intervention criteria in 5 sessions with an overall mean 80 Stephanie Sokolosky, Texas Tech University, May, 2011 of 75% for correct tasks completed during intervention. During intervention session 2, when a large group of students entered the hall, Jerry became distracted. Jerry‘s correct tasks completed were 100% for intervention sessions 3 and 4, and 88% for intervention session 5. Jerry‘s generalization sessions were 100% for the correct tasks completed for each session, indicating that he was able to use the skill in novel settings.
Figure 2. Jerry‘s performance during the baseline, intervention, and generalization
phases Baseline Intervention Generalization
actions
of correct of correct
Percentage
Sessions Jim. During baseline, Jim‘s percentage of correct tasks completed was 43%. Jim showed substantial improvement for the intervention phase and with the use of video modeling his percentage correct tasks completed increased to a mean of 81% in 10 sessions. There was decreasing a trend in the intervention session 2 because he was covering his eyes with his hands, peeking through his hands at the teacher, turning around instead of walking the correct direction down the hall, and generally not attending to the training program. However, for the remainder of the intervention sessions 4 through 10, his mean score was 86% for the completion of correct tasks which was above mastery
81 Stephanie Sokolosky, Texas Tech University, May, 2011 criterion. All of Jim‘s generalization sessions resulted in 100% correct tasks completed.
Consequently, this method was effective as a means of training Jim to learn a new skill.
The generalization sessions exemplified Jim‘s ability to demonstrate the skill in novel settings.
Figure 3. Jim‘s performance during the baseline, intervention, and generalization
phases Baseline Intervention Generalization
actions
Percentage of correct Percentage
Sessions Monte. Although Monte‘s baseline data decreased, baseline sessions 2 and 3 were consistent at 0% of correct tasks completed, as Monte refused to walk down the hall.
After viewing the video, the mean scores for intervention sessions 1 and 2 were 69% for correct tasks completed. However, intervention sessions 3 and 4 were both 13%. While
Monte was viewing the model video during intervention session 7, a large group of additional children entered the hall, and the data for that session was 13% correct actions.
Data from the overall intervention phase showed variability. Monte‘s mean percentage for correct tasks completed for the first two intervention sessions was 69%. The percentage for correct tasks completed then dropped to 13%, followed by an increase to
82 Stephanie Sokolosky, Texas Tech University, May, 2011
75%, then another drop to 13%. The four subsequent intervention sessions averaged 94% for correct tasks completed. With a fluctuation from 13% to 100% correct tasks completed for intervention sessions 7 and 8, it is unlikely that a skill deficit was a probable explanation of the drop to 13%. The fluctuations may have more likely been the result of possible efforts to gain attention from the other students or the teacher. For the generalization phase, Monte scored 86% for correct tasks completed for all three sessions. During the generalization sessions, Monte imitated the correct tasks demonstrated in the video model, even though he was leaning over and dragging one foot while looking at the teacher. In spite of his antics, Monte learned the safety skill modeled in the video. Monte was able to generalize this skill to novel settings.
Figure 4. Monte‘s performance during the baseline, intervention, and generalization
phases
Baseline Intervention Generalization
Percentage of correct actions of correct Percentage Sessions Richard. Richard‘s baseline mean was 19% of correct tasks completed and stable. After viewing the video model, all of Richard‘s responses were 100% for correct tasks completed with a significant increase in level. The graphic display represents the
83 Stephanie Sokolosky, Texas Tech University, May, 2011 effectiveness of this method for teaching Richard this safety skill. Following the initial viewing of the video, Richard repeated many of the words from the video model narration. Richard‘s generalization scores were all 100% for correct tasks completed, reflecting his ability to generalize the training to a novel setting within the school.
Figure 5. Richard‘s performance during the baseline, intervention, and
generalization phases
Baseline Intervention Generalization
tage actions of correct
Percen
Sessions Summary of Participants
The results of the individual data from the participants were summarized in response to the research questions. Is video modeling an effective method for teaching the safety skill of walking around yellow markers that indicate a wet area? Yes, all of the participants were able to learn this skill using video modeling. Video modeling may be an effective method for teaching this safety skill to these students.
The second research question addressed the generalization of the safety skill across settings. All of the participants demonstrated generalization of the skill to a novel 84 Stephanie Sokolosky, Texas Tech University, May, 2011 setting. The generalization scores ranged from 86%, indicating completion of all but one correct task, to 100% indicating the completion of all the correct tasks. Video modeling may be effective in providing the participants training that generalized to a novel setting.
Treatment Acceptability
The teaching staff completed the treatment acceptability forms as a team. The teaching team participated in the training sessions and based their responses on their direct observations as well as a review of the participant data. Based on the teacher ratings, Monte and Brad received 100% Agree, while the three other students received
100% Strongly Agree responses. Teacher input supported the suggestion that Monte may benefit from another intervention because he enjoyed being videotaped and sometimes found it difficult to focus his attention on the purpose of the study, to model the teacher‘s behavior of safely walking around the yellow markers. However, the teachers stated that video modeling may be recommended for teaching Monte if the protocol included an explanation of the importance of modeling the tasks from the video. In spite of Monte‘s distractions, he was able to learn the skill using video modeling, and for that reason they described video modeling as an acceptable method for teaching Monte a new skill.
With respect to Brad‘s results, the teachers suggested that he may have benefitted more from a teaching model with individualized instructions, rather than a standardized video tape. In spite of Brad‘s sensory distractions and his interest in the large group of other students in the hall, he was able to learn the safety skill using video modeling. The teacher reported that Brad‘s intellectual level was lower than the other students in the group, and that may have contributed to his need for more intervention sessions to reach criterion. Brad learned the skill and generalized it to a novel setting, and the teachers 85 Stephanie Sokolosky, Texas Tech University, May, 2011 consequently described this method as effective for teaching Brad the safety skill.
However, the teachers suggested that another method based on a more direct instructional method may have been more efficient for Brad‘s learning style.
The other three students, Jerry, Jim and Richard, all received 100% Strongly
Agree responses from the teachers. Consequently, the teachers reported that the video modeling teaching method may have been successful for these three students, and would recommend it for learning other skills.
The parent treatment acceptability responses were based on viewing a selection of videos sessions of their child, reviewing their child‘s data reflecting the percentage correct tasks completed for each video, and discussing the treatment method with the researcher. All of the parent responses were within the top categories of Strongly Agree and Agree. After reviewing the study results, the responses from the parents of Brad,
Richard and Jim were 100% in the Strongly Agree category. The parents of these three participants concluded that video modeling was effective for teaching the safety skill, and were interested in using this teaching method for other skills.
Richard‘s parents were interested in using video modeling for training new skills because Richard‘s responses after viewing the video were 100% correct tasks completed for all of the intervention and generalization sessions. Although the family primarily speaks Spanish at home, they expressed appreciation of any effort contributing to
Richard‘s use of the English language. The family was pleased that Richard repeated segments of the English narration while correctly modeling the tasks. His family requested assistance in using video modeling for teaching Richard other skills.
86 Stephanie Sokolosky, Texas Tech University, May, 2011
Monte‘s parent‘s responses were 100% in the Agree category. After reviewing the data, Monte‘s parent was pleased with the results and Monte‘s ability to learn the safety skill using the video modeling method. Monte‘s parent reported that he enjoyed being videotaped at home and ―putting on a show for the camera.‖ The parents suggested that if
Monte could receive instruction clarifying that the purpose of this video session was to learn a specific skill, he may have more consistently modeled the tasks from the video. In spite of the data variability, the parents expressed an interest in using video modeling for teaching Monte other skills.
The responses from Jerry‘s parents were split with 53% in the Agree category, and 47% in the Strongly Agree category. When the study results were shared with the parents, they made favorable comments about the treatment method, and reported that the safety skill was important. The parents described Jerry as an ―active‖ child and expressed a specific interest in safety training in order to prevent unintentional injuries.
The parents consistently expressed positive reactions to the use of the video as a training model. Richard and Monte‘s parents inquired about using video modeling at home for training other skills, such as tying shoes and performing simple chores.
Overall, the teachers and parents agreed that the use of video modeling may be an effective intervention with the participants and they would recommend this method to others.
87 Stephanie Sokolosky, Texas Tech University, May, 2011
Chapter V Discussion
The purpose of this study was to assess the effectiveness of using video modeling for teaching a safety skill to five young children with developmental disabilities, including autism. The following research questions were addressed in this study (a) Is video modeling an effective method for teaching the safety skill to young children with developmental disabilities and autism? and, (b) Will the safety skill learned through video modeling generalize across settings? In this chapter, results are discussed within the context of literature. In addition, suggestions for future researchers, limitations of the study, and conclusions are presented.
Research Question 1: Is video modeling an effective method for teaching the safety skill to young children with developmental disabilities?
The purpose of this question was to assess the effectiveness of using video modeling for teaching young children the safety skill of walking around the yellow markers. The findings confirmed that video modeling may be an effective method for teaching the safety skill across all five participants.
In comparing this study with other similar studies, only two in which video methods were used to teach safety skills to individuals with developmental disabilities, could be found (Mechling et al., 2009; Tiong, et al., 1992). Both Mechling et al. (2009) and Tiong‘s et al. (1992) studies used participants who were significantly older than the participants in the current study, and both explored safety skills regarding fire. In
Mechling‘s et al. study, the students, ranging from 19 to 21 years, used video modeling to learn three fire extinguishing behaviors. In Tiong‘s et al. study, the three participants, 88 Stephanie Sokolosky, Texas Tech University, May, 2011 ages 21 to 35, used video prompting for learning to safely exit their bedrooms in case of fire. In addition, the data from the pilot study (Sokolosky, 2010) were consistent with this research study. In all three studies described above, the results were similar to the results of the current study and the participants were successful in learning the targeted safety skills using video modeling. Even though, the participants in the current study and the author‘s pilot study were much younger than the participants in the Mechling and
Tiong studies, the results suggest the effectiveness of using video modeling for teaching a safety skill.
The participants in the current study varied in their ability to acquire the safety skill. Brad‘s baseline was the most stable at 48% correct tasks completed for three baseline sessions, whereas the mean percentage of correct tasks completed for the other participants during the baseline phase was 26%. However, the length of time or number of intervention sessions to reach criterion for Brad was 16, in contrast to mean of 8 for intervention sessions for the other participants. These differences may be attributed to the teacher‘s report of higher intellectual ability of the other four participants in comparison to Brad‘s intellectual ability. In addition, during some of the sessions, Brad became distracted when lightly chewing on his tongue or gently folding his ear with his fingers; these behaviors may have interfered in completing the safety skill tasks demonstrated in the video. Although these behaviors may have contributed to Brad‘s distraction, the behaviors were not severe, nor did they pose a danger to the student.
Another variable may have been Brad‘s slow walking pace. Periodically, when Brad walked down the hall at a very slow pace, it was difficult to determine whether he slowed down at the yellow marker. Future researchers should investigate whether motor abilities 89 Stephanie Sokolosky, Texas Tech University, May, 2011 such as walking pace, and/or gait impacts safety skill acquisition in individuals with developmental disabilities.
Since the study was conducted in a natural setting, other variables may have impacted the study results. One variable included some of the participants‘ distractibility when a large number of students entered the hall during the sessions. Another variable was one student‘s interest in being videotaped, and acting for the video rather than completing the correct tasks. When a small number of students (one to four at a time) walked down the hall during the sessions, the participants were able to maintain their focus on completing the correct tasks as demonstrated in the video. However, Jim appeared to have difficulty maintaining his focus on modeling the target behaviors when a large group (up to 50 students) was in the hall. During one session, a large group of students entered the hall while Jim was viewing the video. Consequently, on his intervention session 3, his percentage correct tasks completed dropped to baseline level.
The trend of Jim‘s percent correct tasks completed represented consistent improvement for the remainder of the sessions. Jim‘s mean percentage of correct tasks completed during intervention was 89%, when the 38% score was factored out of the total intervention. The large groups of students may have also had an impact on Monte‘s performance. Future researchers may want to compare the results in a setting with no additional people in the proximity of the video modeling study, with the results in a setting where a small or large group of people is in the vicinity.
Another variable that possibly contributed to participants‘ distractibility from completing the correct tasks was Monte‘s apparent interest in being videotaped. When
Monte noticed he was being videotaped, he slumped his shoulders, and dragged one foot 90 Stephanie Sokolosky, Texas Tech University, May, 2011 down the hall, and was playful with behaviors such as laughing, dancing around, then stooping down, and quickly jumping up. At Monte‘s third and fourth intervention sessions, he exhibited these behaviors instead of completing the correct tasks demonstrated in the video. During the fifth intervention session, Monte modeled the target behaviors, then again at intervention sessions 6 and 7, he exhibited the undesirable behaviors that may have been an effort to gain attention. Following intervention session
7, Monte‘s level of cooperation increased and he exhibited significant improvement with a mean percentage correct tasks completed of 94% for the remaining intervention sessions. Overall, after factoring out the results from the sessions in which Monte was exhibiting the playful behaviors for the camera, Monte demonstrated an increasing trend of correct task completion, particularly when compared to the results from his baseline sessions. In spite of the variable behaviors, Monte demonstrated his ability to learn the safety skill using video modeling. Future researchers may want to identify subjects who express an interest in exhibiting playful behavior for the camera and use other data collection methods, or develop an effective way to redirect the student‘s attention focus if videotaping is used for data collection.
Richard‘s response was the most positive for the use of video modeling as an intervention. As soon as Richard viewed the video, he precisely completed the correct tasks that he had seen in the video model in every intervention session, as well as each generalization session. His percentage correct tasks completed for all intervention and generalization sessions was 100%. There were initial concerns about the use of English narration because Richard lived in a home where Spanish was the dominant language.
Although he received daily bilingual services at school, his instruction was delivered in 91 Stephanie Sokolosky, Texas Tech University, May, 2011
English. After viewing the video one time, Richard repeated several of the English phrases, in addition to completing100% of the correct tasks. The research team concurred that the use of English for narrating the video resulted in no negative impact on
Richard‘s acquisition of the safety skill.
Jerry‘s ability to complete the correct tasks modeled was mediated by medication adjustments. The medication, Intuniv, affected Jerry‘s sleep patterns, and if he were lethargic when he arrived in the morning, the teacher allowed him a brief rest time. At intervention session 2, Jerry completed breakfast and had briefly fallen asleep when the teacher awakened him to participate in the intervention session. Jerry completed 38% of the correct tasks during that session, in contrast to 85% mean correct tasks completed for the other intervention sessions. A schedule adjustment was made and Jerry was able to reach criterion on the following three intervention sessions. After the medication concern was accounted for, video modeling may be considered an effective intervention for Jerry.
There are some inherent reasons that many children, including children with autism may prefer using video modeling as a training method. Individuals with autism frequently exhibit features that contribute to the effectiveness of video modeling with this population. Many individuals with autism tend to exhibit over-selective attention to detail (Charlop-Christy & Daneshvar, 2003), show preference for visual stimuli (Shipley-
Benamou, Lutzker, & Taubman 2002), and express preference for visually cued instruction (Quill, 1977). Since a video is primarily a visual medium, it may be reinforcing to children with autism (Charlop-Christy et al., 2000). Viewing video is associated with recreation and is naturally motivating to many children, and often
92 Stephanie Sokolosky, Texas Tech University, May, 2011 reinforcing to children with autism (Charlop-Christy et al., 2000; Wert & Neisworth,
2003; Charlop-Christy & Daneshvar, 2003).
There are additional advantages to learning through video modeling described by
Thelen, Fry, Fehrenbach and Frautschi (1979). Some of the advantages include the following: (a) ability to present a variety of examples and settings, (b) consistent modeling, (c) repetition of the same model, and (d) reuse of the video with different trainers. These qualities descriptive of video modeling contribute to generalization of the skills. In general, video modeling may lead to more efficient learning because it may be intrinsically reinforcing (Charlop-Christy, & Daneshvar, 2003).
The current study differed from the majority of other video modeling studies because video modeling was used alone as the independent variable. In many studies, even though video modeling may have been the primary independent variable, it was frequently combined with other instructional prompts or reinforcers. In one review,
Delano (2007) examined 19 studies published between 1985 and 2005 where video modeling interventions were used with individuals with autism. Sixteen of the studies combined video modeling with other intervention components, whereas only three used video modeling as a single intervention. Reviewing studies from 1980 to 2008, Shukla-
Mehta et al. (2010) evaluated the effectiveness of using video instruction for teaching social and communication skills to children with ASD. The authors identified 26 studies in which only 5 of those studies was video modeling a single intervention. In a third review of video modeling and video self-modeling, Bellini and Akullian (2007) reviewed
23 studies from 1987 to 2005, and identified four studies where video modeling or video self-modeling was used as an intervention without additional training components. The 93 Stephanie Sokolosky, Texas Tech University, May, 2011 current study contributes to the limited literature where video modeling was the only independent variable.
The age of the participants is another component where the current study differs from most of the other safety studies, particularly those using video modeling as an intervention. Mechling (2008) completed a thirty-year review of safety skill instruction for individuals with developmental disabilities. The literature from 1976 to 2006 focused on teaching personal safety skills to that population, yet only three of the studies included children as the participants. Safety skill training is another category where the current study contributes to the current literature on teaching safety skills to young children with developmental disabilities.
Results of this study point to several possible future research areas.
Reinforcement is a component that would be a natural addition for most teachers and parents when implementing a video modeling intervention. In the current study, completion of the modeled tasks was acknowledged by the teacher, but the students were not reinforced for correctly completing the tasks. A structured reinforcement may be an area of future research. In addition, error correction was not provided for the participants in the current study. Future studies may want to use error correction strategies and assess the outcomes. The students in this study were prompted to first watch the video model, then to complete the correct tasks modeled in the video. Assessing the impact of various prompts, including systematic prompt fading, may enhance the results and should be investigated further. Another future research suggestion is to train older children in a safety skill using video modeling as a single independent variable. Finally, future research may use video modeling with a child as the model instead of an adult. 94 Stephanie Sokolosky, Texas Tech University, May, 2011
Overall, video modeling may be an effective intervention for young children with developmental disabilities, including autism, for training a safety skill. The existing research in video modeling and safety training lends support to this intervention model.
This study extends the current base of knowledge to include the use of video modeling to train a safety skill to young children with developmental disabilities. In addition, it contributes to the literature supporting the effectiveness of video modeling as a single intervention.
Research Question 2: Will the safety skill learned through video modeling generalize across settings?
The generalization of a safety skill is essential if the skill is to be functional in the community. The setting for the current study was a hallway in a public school, which was a natural setting for the use of yellow safety markers used to indicate a wet area.
During the generalization phase, the yellow markers were moved to another location in the school. All of the participants successfully completed the correct tasks in the generalization phase.
The current study was consistent with the two previous studies in which the participants successfully performed their newly learned safety skills in the generalization phase. Researchers in the two other studies used video modeling for teaching a safety skill to individuals with developmental disabilities (Mechling, et.al., 2009; and Tiong, et al., 1992). Mechling et al. (2009) taught the students to extinguish fires in the kitchen, then generalized the skill to the barbeque area outside the living skills training apartment.
Tiong et al. (1992) generalized the skill of safely exiting a community house in the event of a fire, to exiting another residence. Although the present study targeted a different
95 Stephanie Sokolosky, Texas Tech University, May, 2011 safety skill with younger children with developmental disabilities, the results were consistent with the prior research.
In Mechling‘s (2008) thirty-year review of safety studies, 18 out of 30 studies reported the inclusion of generalization phases. In the current study, the generalization strategy was a mediated generalization (Cooper et al., 2007). In this strategy of transferring the safety skill from the intervention to generalization setting, the contrived mediating stimulus (i.e., the yellow safety marker) was transported to the generalization setting to create an environment where the participant was able to perform the skill.
Selecting this portable stimulus made the generalization phase practical. Including a generalization phase when training a safety skill provides additional opportunities for the participants to practice this skill in a natural setting.
There are several suggestions for future investigations that could extend the safety literature beyond the generalization results of this study. Two suggestions include placing the safety markers in another type of public building (e.g., a store), or using safety markers that differ from the one in the training video used during the intervention phase. Additional suggestions that may extend the results include having another adult, instead of one of the teachers, provide the intervention, or accompany the participant to another setting for the generalization session. Another consideration would be to conduct a generalization session in a busy public setting since that is the natural location for these markers.
In any safety training, the generalization phase is one of the most important components of the study. If the student is unable to generalize the newly-learned skill to
96 Stephanie Sokolosky, Texas Tech University, May, 2011 a setting where the safety concern may exist, it may be worthwhile to question the validity of using the time and resources for teaching the skill.
Limitations
Even though this study pertains to an intervention that may have been effective in increasing and generalizing a safety skill across the participants, there were several limitations that should be noted and results should be interpreted with caution. The first major limitation was the use of an AB research design. Literature indicates that an AB design provides a weak functional relationship between the independent and dependent variables (Alberto & Troutman, 2009). Although the results are favorable, a multiple baseline design across subjects may provide a more robust functional relationship.
The second limitation was the lack of availability of the individual assessment scores. Participants must be adequately described in the research for future researchers to replicate the study. Due to lack of access to the students‘ records, a detailed description of participants was not provided in this study.
The third limitation includes the confounding variables that were present in the natural environment. The participants in this study differed from the pilot study participants in that some of the current study participants displayed off-task behaviors, possibly to gain attention from other large groups of students present in the hall. These behaviors may have interfered with the participants‘ abilities to demonstrate the safety skill. Even though the researcher scheduled sessions based on teacher preference, small groups of students (one to five) walked through the hall during the sessions with no interruption to the study participants. However, even though the intrusion of small
97 Stephanie Sokolosky, Texas Tech University, May, 2011 groups of students was expected, the large groups of students appeared to disturb the ability of some of the participants to correctly complete the tasks. Since a fundamental premise of this study was that these yellow markers were usually found in public areas because they helped the public notice a safety hazard, training in the natural environment was the logical location for this type of safety study.
A fourth limitation may be the resources required in the use of a video method for collecting data. Financial costs were incurred for the expense of the video camera,
DVDs, DVD viewing equipment and a computer with the capacity to manipulate the video clips. Another significant resource is the time involved in creating the model video, organizing the video clips and creating a DVD for the independent observer to review. In obtaining parent information for treatment acceptability, the parents were shown a DVD of representative sessions from their child‘s baseline, intervention and generalization study sessions. Preparing the DVDs requires an additional time commitment from the researcher.
The fifth limitation is the importance of carefully crafting the video model to avoid extraneous variables that might distract viewers from the modeled behavior. This may also be considered a limitation because the real world is seldom free of distractions.
Even though most research projects are designed to avoid interruptions, children are likely to encounter the safety markers in locations with confusing stimuli. In spite of the limitations, this study contributes to and extends the current literature on the use of video modeling for teaching safety skills to young children with developmental disabilities, including autism.
98 Stephanie Sokolosky, Texas Tech University, May, 2011
A final limitation is the necessity that safety training remain as safe as possible.
One concern when teaching safety skills is that the environment needs to remain safe during all training phases (Collins & Griffen, 1996; Collins, Stinson, & Land, 1993).
Although the yellow markers were designed to indicate a wet area, during this study there were no wet areas at the training location. Attention to safety for the participants is a necessity, particularly if the participants have developmental disabilities.
Implications for Practice
The results of this study provide implications for practice. When training in a safety skill using video modeling, it is important to clearly identify the target skill.
Teachers and parents would benefit from specific training in methods for identifying and accurately describing a skill. In the area of technology, there are several practical suggestions. The video model needs to be simple, with distinct behavior tasks clearly represented in the video. If a narration is used, the precise words need to be carefully selected and at the participant‘s level of understanding. It is important to record the video segment in precisely the same location as the intervention, eliminating any competing and unnecessary stimuli. The camera for taping the video of the participant, and the equipment to view the video need to be battery-operated so there is no restriction based on electrical outlet locations. If the student enjoys being video-taped, and exhibits off- task behaviors not shown in the video model, it may be useful to employ a systematic desensitization of the camera technique by using the camera extensively in the classroom until the students are accustomed to it. After the camera is used in the classroom, the presentation of the camera as a discriminative stimulus for off-task behaviors may decrease. Finally, technological improvements continually simplify the procedures for 99 Stephanie Sokolosky, Texas Tech University, May, 2011 capturing and manipulating video clips, thus parents and teachers may be able to use videos for instruction more quickly and efficiently.
Another consideration is the cost of the video equipment, DVDs, software for manipulating the videos and access to a computer. In addition, technical support will need to be available for learning technical steps of capturing the video, downloading it to a computer, properly labeling the video clips, and organizing the video clips for each student. Another resource is the time involved in learning to use the technical equipment to complete the project, as well as capturing a good video of the skill being modeled.
A final implication for practice is the importance of addressing implementation fidelity of the intervention. There were two crucial components of the intervention in the study: the consistent use of prompting and reinforcing statements across participants.
The teachers helping with the intervention must adhere to the requirement to consistently prompt each student to first watch the video, then to walk down the hall, using the same prompt across students. After completing the correct tasks, the teacher must provide a consistent reinforcing statement that simply acknowledges walking down the hall while attending to the safety markers. Since error corrections were not included, the teacher must provide neutral comments acknowledging completion of the task. Attention to the fidelity of implementation assures consistency across participants, so the effectiveness of the intervention can be evaluated.
Conclusions
In conclusion, the results of this study indicated that the use of video modeling for teaching the safety skill of safely walking around yellow safety markers was an effective
100 Stephanie Sokolosky, Texas Tech University, May, 2011 intervention for all of the participants. The participants responding the most efficiently to the model had the highest intellectual ability, based on teacher report. Subsequently, the participant requiring the most sessions to reach criterion exhibited the most severe intellectual deficits, as described by the teacher. Although there were individual differences, all of the participants learned the safety skill using video modeling, then repeated the desired behavioral responses in novel settings. Parents and teachers were satisfied with the results, and both groups discussed their interest in using this method with other interventions. One parent requested that the researcher help her at home for learning self-help skills. The teachers appreciated the method as a more desirable alternative to repetitive lecturing.
This study, along with the other previous video modeling studies, provides support for using video modeling as an intervention for children with developmental disabilities and autism. In this study, the acquisition of this important safety skill was accomplished solely through video modeling. The positive outcomes of this study suggest that video modeling may be an effective tool for practitioners, including teachers and parents. This study contributes to the literature that addresses teaching safety skills to young children with developmental disabilities using a video modeling intervention.
In addition, the results of this study support the notion that video modeling may be particularly suitable for young children with autism.
101 Stephanie Sokolosky, Texas Tech University, May, 2011
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Appendix A Task Analysis List
Interventionist: ______
Date: ______Setting: ______
Task Observed Not observed Comments Walk
Walk in one direction toward Marker 1 Slow down or stop at Marker 1 Walk toward Marker 2 Slow down or stop at Marker 2 Continue walking down the hall in the same direction
Percentage correct steps
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Appendix B Texas Tech University IRB Signature Page
125 Stephanie Sokolosky, Texas Tech University, May, 2011
Appendix C Invitation to Participate
Dear Parent:
We are writing to inform you of an opportunity for you to participate in a research study. This study will be conducted with students with disabilities exhibiting problem behaviors in the area of safety. We are looking for participants who are likely to exhibit problem behaviors in this area because they may not notice a wet area on the floor, which may cause them to slip and fall. However, for purposes of the study, the floor will be marked with a safety marker, but the floor will not actually be wet. Before conducting this study, we will also obtain written consent from you and permission from the school principal to conduct the study. Our study will examine the effectiveness of using video modeling for teaching the safety behavior of avoiding wet areas on the floor. During this study, we will use a video modeling method for teaching student safety. Before the training, the video will be viewed by the student. The student will be provided with minimal prompting and reinforcement for participation. This study will be conducted in conjunction with regular class instruction. The teacher or designated school staff person will spend 15-20 minutes each day when the training occurs, teaching safety. We will observe and record your child‘s behavior. We will not be interacting with the student. At the end of the study, you will be informed of the overall results. This study has been approved by the Institutional Review Board (IRB) of Texas Tech University. There are no risks involved in this study as this study will be conducted on floor that is not wet. This study is likely to improve your student‘s ability to exhibit safe behavior when approaching a wet area on a floor or street at school and in the community. Your participation will help establish the research base for an effective intervention for this important component of your child‘s behavior. In addition, our research could help parents and other professionals determine how these intervention methods could benefit their children/students. We look forward to the opportunity of working with your child. If you have any questions, please feel free to contact Devender Banda, Assistant Professor, College of Education, Texas Tech University, Lubbock, TX (806-742-1997 x 305); email [email protected] or Stephanie Sokolosky at [email protected].
______Devender R. Banda, Ph.D., BCBA Assistant Professor of Special Education
126 Stephanie Sokolosky, Texas Tech University, May, 2011
Appendix D District Research Approval (Best available copy)
127 Stephanie Sokolosky, Texas Tech University, May, 2011
128 Stephanie Sokolosky, Texas Tech University, May, 2011
Appendix E Parent Consent Form
Title of the project: Effectiveness of using video modeling in teaching safety skills to children with autism or developmental disabilities.
Helping your child by being a part of our research team.
Children can sometimes exhibit behaviors as a pedestrian that does not demonstrate a respect for simple safety rules. Long-term display of these problem behaviors can place the child at risk of injury. Furthermore, the role of safety when walking around wet floors to avoid a fall is always extremely important. We plan to help your child by providing simple behavioral interventions to increase the knowledge and practice of safety behaviors. The purpose of this study is to complete research on this safety practice.
What we will do.
We will observe your child in the school when he/she exhibits the target behavior of unknowingly walking toward a sign indicating wet floor. We will be in the school/classroom for 10-15 minutes each day for 3-4 days in a week for 15-20 weeks during fall and/or spring semesters. The time of the day we observe will be set by the teacher at the beginning of the research. We will interview the classroom teacher to collect any additional information. We will introduce a method of walking around the yellow plastic marker used for designating wet floor. For the safety of the student, we will use non-wet areas for training purposes. During this time, we will record his behaviors. We will video tape the sessions for purposes of data collection and data analysis. We will determine if your child needs additional intervention in this safety- related area. All interventions will be conducted by the teacher or teaching staff during typical classroom activities without loss of any instructional time. This study will be supervised by the principal investigator who is a trained behavior analyst.
129 Stephanie Sokolosky, Texas Tech University, May, 2011
We will visit with you and your child‘s teacher about the need for safety training. In addition, we will interview the teacher about any additional information that may contribute to our success. We will introduce a method for safety using video modeling, where the child with watch a brief video, approximately 2 minutes in length, then he will be trained to imitate the safety tips for walking around wet areas on the floor marked by a yellow plastic marker, using positive methods. During this time, we will record your child‘s behavior and determine the behaviors that your child needs to learn and practice in order to safely walk around wet areas. All interventions will be conducted by the teacher or teaching staff. This study will be supervised by the principal investigator who is a trained behavior analyst.
What you will do.
In order for your child to participate in the study, you will be required to read and sign this consent. The researcher will contact you by telephone or email to make an appointment for an interview at a location and time that is convenient for you. The meeting will last approximately 20 to 30 minutes. We will discuss the consent form during this meeting, and you will provide a signature indicating your agreement with the program. You will retain a copy of this signed consent form, and the researcher will receive a copy of the signed consent form. We will discuss your child and the researcher will gain an understanding of your child‘s need for this type of safety training, There are no known risks of participating in this study.
It's private information.
All of the information we get will be private (confidential) and your child‘s name will not be used anywhere. No other person will have access to the data other than the investigators. The data will be kept with the principal investigator in a locked room.
130 Stephanie Sokolosky, Texas Tech University, May, 2011
If you have any questions about this study please contact Dr. Devender Banda by phone (806 742 1997 x 305) or email ([email protected]) or Stephanie Sokolosky at [email protected].
For questions about your rights as a subject or about injuries caused by this research, contact the Texas Tech University Institutional Review Board for the Protection of Human Subjects, Office of Research Services, Texas Tech University, Lubbock, Texas 79409. Or you can call (806) 742-3884.
You do not have to participate in this research project. If you agree to participate you can withdraw your participation at any time. In addition, you can decline to answer specific questions.
Yes, I have read the information above and agree to participate in this study. Further, I understand that this is voluntary.
Student's Name:______
Parent‘s Signature______Date: ______
Consent Form Expires on ______
131 Stephanie Sokolosky, Texas Tech University, May, 2011
Appendix F Parent Consent Form (Spanish)
Formulario de consentimiento de los padres
Título del proyecto: Efectividad al usar indicaciones mediante el video en las abilidades de seguridad del profesor para niños con autismo o desarrollo de discapacidades
Ayudando a su niño ser parte de nuestro equipo de investigación. Los niños a veces pueden exhibir conductas como una persona que camina que no demuestra respeto de las sencillas reglas de seguridad. La exposición prolongada de estos problemas de conducta puede poner al niño en riesgo de lastimarse. Además, el rol de seguridad al caminar por el piso mojado y evitar la caída siempre es extremadamente importante. Planeamos ayudar a su niño proveyéndole simples intervenciones de comportamiento para mejorar el conocimiento y la práctica de conductas de seguridad. El propósito de este estudio es completar la investigación de esta práctica de seguridad.
Qué hacer. Observaremos a su estudiante en la escuela cuando él/ella exhibe esta finalidad de conducta de caminar sin conocer hacia la señal de piso mojado. Estaremos en la sala de clase de la escuela por 10 a 15 minutos cada día de 3 a 4 días en una semana por 15 a 20 semanas durante los semestres de otoño y/o primavera. El tiempo del día que observemos será fijado por el profesor al inicio de la investigación. Le entrevistaremos, y el profesor de la clase, para recolectar cualquier información adicional. Le presentaremos un método de caminar por la señal de plástico amarilla usada para designar el piso mojado. Para la seguridad del niño, usaremos áreas no mojadas durante el entrenamiento. Durante las sesiones grabaremos la conducta de su niño. Todas las sesiones serán videograbadas con el propósito de recoger información y análisis de información. Las videograbaciones serán guardadas en lugar seguro, un archivo de gabinete cerrado bajo la
132 Stephanie Sokolosky, Texas Tech University, May, 2011 supervisión del investigador primario. Esto asegura confidencialidad y las videograbaciones serán destruidas después de completar con la disertación y publicación de los hallazgos, por el año 2016. Determinaremos si su niño necesita intervención adicional en esta área relacionada de la seguridad. Todas las intervenciones serán dirigidas por el profesor o el personal de enseñaza durante las actividades típicas de clase sin perder ningún tiempo de instrucción. Este estudio será supervisado por el principal investigador que es un analista de conducta entrenado.
Les visitaremos a usted y al maestro de su niño acerca de la necesidad para un entrenamiento de seguridad. Además entrevistaremos al maestro para cualquier información adicional que pueda contribuir al éxito. Les presentaremos un método para uso de seguridad de video modelado donde el niño mira un video por aproximadamente dos minutos de extensión, y luego será entrenado para imitar consejos de seguridad para caminar por áreas mojadas en el piso marcadas con plástico amarillo, usando métodos positivos. Durante este tiempo grabaremos la conducta de su niño y determinaremos la conducta que su niño necesita aprender y practicar para caminar en áreas mojadas. Todas las intervenciones serán conducidas por el maestro o por el personal de enseñanza. Este estudio será supervisado por el principal investigador que es un analista de conducta entrenado.
Qué harás. Para que su niño participe en el estudio, se requerirá leer y firmar este consentimiento. El investigador se contactará con usted por teléfono o email para hacer una cita de entrevista en un lugar y tiempo que sea conveniente para usted. La reunión durará aproximadamente de 20 a 30 minutos. Discutiremos el formulario de consentimiento durante esta reunión y usted proveerá una firma indicando su acuerdo con el programa. Usted retendrá una copia de este formulario de consentimiento firmado, y el investigador recibirá una copia del formulario del consentimiento firmado. Hablaremos sobre su niño y el investigador entenderá la necesidad de su niño para este tipo de entrenamiento de seguridad. No hay ningún riesgo en este estudio.
133 Stephanie Sokolosky, Texas Tech University, May, 2011
Es una información privada. Toda la información que conseguiremos será confidencial. Y el nombre del niño no será usado en ninguna parte. Ninguna otra persona mas que el investigador tendrá acceso a esta información. La información será guardada con el principal investigador en un cuarto asegurado.
Si usted tiene alguna pregunta acerca de este estudio, por favor contáctese con el Doctor Devender Banda por teléfono (806) 742-1997 x305) o email ([email protected]) o Stephanie Sokolosky ([email protected]).
Para preguntas acerca de sus derechos como participante o acerca de los daños causados por esta investigación contáctese con Texas Tech Institutional Review Board for the Protection of Human Subjects, Office of Research Services, Texas Tech University, Lubbock, Texas 79409. O puede llamar al (806) 742-3884.
Usted no tiene que participar en este proyecto de investigación. Si usted quiere participar puede retirar su participación en cualquier momento. Además, puede negarse a responder a específicas preguntas. Sí, yo he leído la información de arriba y acepto participar en este estudio. Además, entiendo que esto es voluntario.
Nombre del estudiante: ______Nombre del padre o tutor: ______Firma del padre o tutor: ______Fecha: ______
El formulario de consentimiento expira en ______
134 Stephanie Sokolosky, Texas Tech University, May, 2011
Appendix G Teacher Consent Form
Title of the project: Effectiveness of using video modeling in teaching safety skills to children with autism or developmental disabilities
Helping your child by being a part of our research team.
Children can sometimes exhibit behaviors as a pedestrian that does not demonstrate a respect for simple safety rules. Long-term display of these problem behaviors can place the child at risk of injury. Furthermore, the role of safety when walking around wet floors to avoid a fall is always extremely important. We plan to help your child by providing simple behavioral interventions to increase the knowledge and practice of safety behaviors. The purpose of this study is to complete research on this safety practice.
What we will do.
We will observe your student in the school when he/she exhibits the target behavior of unknowingly walking toward a sign marking a wet floor. We will be in the school/classroom for 10-15 minutes each day for 3-4 days in a week for 15-20 weeks during fall and/or spring semesters. The time of the day we observe will be set by the teacher at the beginning of the research. We will interview you, the classroom teacher, to collect any additional information. We will introduce a method of walking around the yellow plastic marker used for designating wet floor. For the safety of the student, we will use non-wet areas during the training. At this time, we will record his behaviors. We will video tape the sessions for purposes of data collection and data analysis. We will determine if your child needs additional intervention in this safety-related area. All interventions will be conducted by the teacher or teaching staff during typical classroom activities without loss of any instructional time. This study will be supervised by the principal investigator who is a trained behavior analyst.
135 Stephanie Sokolosky, Texas Tech University, May, 2011
We will visit with you about the need for safety training. In addition, we will interview you about any additional information that may contribute to our success. We will introduce a method for safety using video modeling, where the child watches a brief video, then he will be trained to imitate the safety tips for walking around a specified area on the floor marked by a yellow plastic marker, using positive methods. For purposes of the study, the area under the marker will not be wet. During this time, we will record your child‘s behavior and determine the behaviors that your child needs to learn and practice in order to safely walk around areas designated by the safety markers. All interventions will be conducted by you or other designated school personnel. This study will be supervised by the principal investigator who is a trained behavior analyst.
What you will do.
In order for your student to participate in the study, you will be required to read and sign this consent. The researcher will contact you by telephone or email to make an appointment for an interview at a location and time that is convenient for you. The meeting will last approximately 20 to 30 minutes. We will discuss the consent form during this meeting, and you will provide a signature indicating your agreement with the program. You will retain a copy of this signed consent form, and the researcher will receive a copy of the signed consent form. We will discuss your student and the researcher will gain an understanding of your student‘s need for this type of safety training, There are no known risks of participating in this study.
It's private information.
All of the information we get will be private (confidential) and the child‘s name will not be used anywhere. No other person will have access to the data other than the investigators. The data will be kept with the principal investigator in a locked room.
If you have any questions about this study please contact Dr. Devender Banda by phone (806 742 1997 x 305) or email ([email protected]) of Stephanie Sokolosky ([email protected]). 136 Stephanie Sokolosky, Texas Tech University, May, 2011
For questions about your rights as a subject or about injuries caused by this research, contact the Texas Tech University Institutional Review Board for the Protection of Human Subjects, Office of Research Services, Texas Tech University, Lubbock, Texas 79409. Or you can call (806) 742-3884.
You do not have to participate in this research project. If you agree to participate you can withdraw your participation at any time. In addition, you can decline to answer specific questions.
Yes, I have read the information above and agree to participate in this study. Further, I understand that this is voluntary.
Student's Name:______
Parent‘s Signature______Date:______
Consent Form Expires on ______
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Appendix H Child Personal Data
Child‘s Name ______DOB: ______Age: ______
Parent‘s Name ______
Last First
Please circle or write the information that applies to your child.
(a) Autism (b) Asperger‘s Disorder (d) Developmental Disability
(e) Other (please specify) ______My child was diagnosed by (a) school personal (b) medical doctor
My child is able to watch and listen to a movie or DVD. (a) yes (b) no
This school year is my child‘s first year in school. (a) yes (b) no
My child uses the following method(s) to communicate
(a) oral language (b) gestures (c) other ______Does your child have any medical conditions of which the researchers need to be aware?
(a) Yes (b) No If Yes, please describe or explain:
______
______
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Appendix I Teacher Training
Use of the video player
Demonstration of the On and Off switches. The interventionist will practice this step. Demonstration of the placement of the DVD in the video player. The interventionist will practice this step. Locate the cord which will be used when the battery needs to be charged. Retain an additional copy of the DVD model video in case something malfunctions with the original video model. Describe to the interventionist that the most efficient way to help the child watch the video is for the interventionist to be seated in the hall, with the child sitting in her lap. The interventionist will select a time when the subject is able to attend to the video, then turn on the video for the subject to observe.
Video Modeling
In this study, the student will go to the hall with the yellow plastic markers, and view the video with the help of the interventionist. During the intervention phase, after viewing the video of the teacher modeling the desired behavior, the student will be prompted to walk down the hall.
Prompting and reinforcement
Prompting to view the video o A verbal prompt is provided by the interventionist immediately preceding the intervention of viewing the video. o In this study, the subject will be prompted to view the video, then prompted to walk down the hall. o It will be important for all of the subjects to be prompted in the same way. o After the student is in the hall where the markers are set up and the video viewer is ready, the interventionist will prompt the student to sit and view the video. o A possible prompt is ―(Name) let‘s watch the video‖.
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Prompting to walk down the hall
o After the subject has watched the video, and is standing prepared to walk down the hall, the interventionist will give a simple prompt. o Possible prompt is ―(Name), walk down the hall‖. o o Another possible prompt is the beginning narration for the video ―OK, when I‘m walking down the hall.‖
Reinforcement o For purposes of this intervention, the interventionist will provide a verbal reinforcement when the student completes steps of walking down the hall. o The reinforcing statement will address completion of walking down the hall, but will not address the quality of completing all of the steps. o An example is ―(Name), you did a good job walking down the hall today.‖ o The goal is to reinforce the completion of the chained task.
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Appendix J Data Collection Form
Interventionist: ______
Date: ______Setting: ______
Circle the Phase: Baseline Intervention Generalization
Student name: Session # Session # Session # Session # Session # ______Date Date Date Date Date ______
Student walks
Walks in 1 direction toward Marker 1
Stops or slows down at Marker 1
Moves to Marker 2
Stops or slows down at Marker 2
Walks past Marker 2 in same direction
Total
Percentage correct
Comments
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Appendix K Data Collection Form –Interobserver Agreement
Interventionist: ______
Date: ______Setting: ______
Name of person completing form: ______
Circle the Phase: Baseline Intervention Generalization
Student name: Session # Session # Session # Session # Session # ______Date Date Date Date Date ______
Student walks
Walks in 1 direction toward Marker 1
Stops or slows down at Marker 1
Moves to Marker 2
Stops or slows down at Marker 2
Walks past Marker 2 in same direction
Total
Percentage correct
Comments
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Appendix L Procedural Integrity Form for Implementer Skill Assessment
Interventionist: ______Student: ______
Date: ______Setting: ______
Name of person completing form: ______
Circle the phase: Baseline Intervention Generalization
Session #______
Skill Yes No Comment Environment is set up properly with markers
Video is ready for student to watch Trainer prompts student to watch video Trainer prompts student to walk down the hall
No additional prompting while walking
Upon completion trainer reinforces student‘s completion
No additional reinforcement for quality of task completion
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Appendix M Teacher Treatment Acceptability Form
Adapted from Intervention Rating Profile-15
The purpose of this questionnaire is to obtain information that will aid in the selection of classroom interventions. The intervention will be used by teachers of children who need to learn safety skills.
Please mark the box that best describes your agreement or disagreement with each statement.
Agree Agree Agree
Slightly Slightly
Strongly Strongly
Disagree Disagree Disagree
1. This would be an acceptable intervention for helping the child learn a new skill. 2. Most teachers would find this intervention appropriate for learning a new skill in addition to the one described. 3. This intervention should prove effective in changing the child‘s behavior to learn to walk around the safety marker. 4. I would suggest this intervention to other teachers.
5. The need to learn this safety skill warrants the use of this intervention. 6. Most teachers would find this intervention suitable for learning this safety skill. 7. I would be willing to use this intervention in the school setting. 8. This intervention would not result in negative side-effects for the child. 9. This intervention would be appropriate for a variety of children. 10. This intervention is consistent with those I have used in classroom settings. 11. This intervention is reasonable for the safety behavior described. 12. This intervention was a fair way to handle the need to learn this safety skill. 13. I liked the procedures used in this intervention.
14. This intervention was a good way to handle this child‘s need to learn this safety skill. 15. Overall, this intervention would be beneficial for the child.
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Appendix N Parent Treatment Acceptability Form
Adapted from Intervention Rating Profile-15
The purpose of this questionnaire is to obtain information that will aid in the selection of classroom interventions. The intervention will be used by teachers of children who need to learn safety skills. Please circle the number that best describes your agreement or disagreement with each statement.
Agree Agree Agree
Slightly Slightly
Strongly Strongly
Disagree Disagree Disagree
1. Using video modeling was an acceptable intervention for helping my child learn a new skill. 2. Some parents would find this intervention appropriate for learning a new skill in addition to the one described (the safety skill). 3. This intervention should prove effective in changing the child‘s behavior to learn to walk around the safety marker. 4. I would suggest this intervention to other parents.
5. The need to learn this safety skill warrants the use of this intervention. 6. Most parents would find this intervention suitable for learning this safety skill. 7. I would be willing to use this intervention (video modeling) in the home setting. 8. This intervention would not result in negative side-effects for the child. 9. This intervention would be appropriate for a variety of children. 10. This intervention is consistent with other methods I have used at home for teaching a new skill. 11. This intervention is reasonable for the safety behavior described. 12. This intervention was a fair way to handle the need to learn this safety skill. 13. I liked the procedures used in this intervention.
14. This intervention was a good way to handle this child‘s need to learn this safety skill. 15. Overall, this intervention was beneficial for the child. 145 Stephanie Sokolosky, Texas Tech University, May, 2011
Appendix O Parent Treatment Acceptability Form (Spanish)
Formulario de validación social
Adoptado de ―Intervention Rating Profile-15‖
El propósito de este cuestionario es obtener información que ayudará en la selección de las intervenciones de clase. La intervención será usada por los profesores de niños que necesiten aprender destrezas de seguridad.
Por favor encierre el número que mejor describa su acuerdo o desacuerdo con cada oración.
cuerdo
en
En
Muy en Muy de
acuerdo
Levemente Levemente Levemente
de acuerdo
desacuerdo desacuerdo desacuerdo
De a De 1. Usar el video modelo fue una intervención aceptable para ayudar a mi hijo/a que aprenda una nueva habilidad. 2. Algunos padres encontrarían apropriada esta intervención para aprender una nueva habilidad, además de la otra descrita (destreza de seguridad). 3. Esta intervención debería ser efectiva en cambiar el comportamiento para que el niño aprenda caminar alrededor de la señal de seguridad. 4. Sugeriría esta intervención a otros padres.
5. La necesidad de aprender esta destreza de seguridad garantiza el uso de esta intervención. 6. Muchos padres encontrarían esta intervención apropriada para aprender esta destreza de seguridad. 7. Quisiera usar esta intervención (video modelo) en casa. 8. Esta intervención no resultaría en efectos secundarios negativos para el niño. 9. Esta intervención sería apropriada para una variedad de niños. 10. Esta intervención tiene consistencia con otros métodos que he usado en casa para enseñar una nueva habilidad. 11. Esta intervención es razonable para el comportamiento de seguridad descrito. 12. Esta intervención fue una manera correcta para manejar la necesidad de aprender esta destreza de seguridad. 13. Me gustan los procedimientos usados en esta intervención. 14. Esta intervención fue una buena manera de manejar esta necesidad de mi hijo/a para que aprenda la destreza de seguridad. 15. Por sobre todo, esta intervención fue beneficiosa para mi hijo/a.
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